Mesotherapy: What is new?

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Date: January-February 2013
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Report
Length: 3,931 words
Lexile Measure: 1610L

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Byline: Deepthi. Konda, Devinder. Thappa

Introduction

"Mesotherapy" is a non-surgical, minimally invasive method of drug delivery that consists of multiple intradermal or subcutaneous injections of a mixture of compounds "melange" in minute doses. [sup][1] Plant extracts, homeopathic agents, pharmaceuticals, vitamins and other bioactive substances can be used, but alcohol- or oil-based substances should not be used for mesotherapy because of the risk of cutaneous necrosis.

The term "mesotherapy" is derived from the Greek words "mesos" meaning " middle 0" or " mean " and "therapeia" meaning "to treat medically," i.e. injecting into the middle layer of skin or "intradermotherapy." [sup][2] The depth of penetration of the needle should not exceed 4 mm for it to be effective. [sup][3]

Despite it being available for over 50 years and the huge publicity and attention received on the Internet, definite evidence for its efficacy is lacking and the claims are not always based on well-conducted clinical trials.

History

Mesotherapy for the first time was developed in 1952 by Dr. Michel Pistor, a French physician for the management of pain and vascular disorders. [sup][4] Pistor coined the term " mesotherapy ." He defined it as treatment of the mesoderm (the primary germ layer that develops into connective tissue, muscle and circulatory system). In 1976, he used the following words to describe mesotherapy: "little volume, few times and in the right place." [sup][3]

Pistor founded the French Society of Mesotherapy in 1964 and, in 1987, The French National Academy of Medicine officially acknowledged mesotherapy as a medical specialty. [sup][4] In the meantime, mesotherapy became popular in most parts of Europe and South America and, more recently, in the United States and Asian countries.

Indications of Mesotherapy

Mesotherapy, like corticosteroids, is claimed to have a wide array of applications especially in the field of cosmetic dermatology. However, only the current and widely practised indications in the field of dermatology along with the drugs used in them are discussed below.

*Body-cellulite, lipodissolve, body contouring (not very effective) *Skin-rejuvenation/glow, lift, pigmentation *Hair-telogen effluvium, androgenetic alopecia Cellulite, local fat deposits and facial rejuvenation show good results with mesotherapy; telogen effluvium, androgenetic alopecia, stretch marks and facial pigmentation show moderate results; whereas body sculpting/contouring and melasma show doubtful results with the same.

An overview of the volume of cocktail to be injected, depth of penetration of mesotherapy needle and number of sessions needed for various uses is given below [sup][5] [Table 1].{Table 1}

Cellulite

Cellulite is an abnormal accumulation of fat above the fascia resulting in dimpling appearance of skin resembling an orange peel. [sup][6] It is most commonly seen in the buttocks and thighs of females. It is seen in both normal and obese persons. It is believed to occur due to abnormality in the venolymphatic system. Therefore, accordingly, the cocktail solution for treatment of cellulite should contain the following agents: [sup][6],[7]

Lipolytic : L-carnitine, caffeine, isoproterenol, thyroxine

Venostatic : rutin, aminophylline, pentoxiphylline

Drainage : Artichoke, gingko biloba

Anesthetic: procaine (also improves circulation)

Connective tissue breakdown : collagenase, hyaluronidase....

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Gale Document Number: GALE|A313659432