Specialist Medical Doctor – Başakşehir Medical Center, Anesthesiology and Reanimation
"A widely known procedure in a broad spectrum ranging from skin rejuvenation to hair loss, from cellulite treatment to localized slimming: Mesotherapy. But what is mesotherapy and why has it become so popular?"
Title:
| WHAT IS MESOTHERAPY? APPLICATION AREAS, BENEFITS, AND SIDE EFFECTS
| Definition and History of Mesotherapy
| Application Techniques of Mesotherapy
| Skin Rejuvenation and Anti-Aging Applications
| Hair Loss Treatment
| Cellulite and Local Fat Reduction (Lipolysis)
| Pain Management and Musculoskeletal Disorders
| Skin Spots and Pigmentation Treatment
| Benefits of Mesotherapy: Fast and Local Effect
| Side Effects of Mesotherapy: Common and Rare
| Suitability and Contraindications for Mesotherapy
| Post-Mesotherapy Care and Recommendations
| Conclusion
WHAT IS MESOTHERAPY? APPLICATION AREAS, BENEFITS, AND SIDE EFFECTS
Mesotherapy is a minimally invasive method used in dermatology and medical aesthetics, involving the microinjection of active substances such as vitamins, minerals, amino acids, enzymes, and hyaluronic acid into the mesoderm layer of the skin (dermis and upper subcutaneous tissue). First developed in 1952 by French physician Dr. Michel Pistor for the treatment of chronic pain, this method is now widely used for aesthetic and therapeutic purposes. Mesotherapy aims to provide local effects by directly intervening in the mesoderm layer of the skin and to minimize systemic side effects.
Definition and History of Mesotherapy
Mesotherapy is derived from the Latin words "meso" (middle) and "therapy," and refers to a treatment aimed at the middle layer of the skin (mesoderm). Initially developed by Dr. Pistor for pain management, this method has become popular over time in aesthetic dermatology and cosmetic applications.
Application Techniques of Mesotherapy
Mesotherapy is applied using 30–32 gauge needles at a depth of 1–4 mm into the mesoderm layer of the skin. Injected substances include hyaluronic acid, vitamins (A, C, E, B complex), minerals (zinc, selenium), amino acids, coenzymes, and lipolytic agents (phosphatidylcholine, deoxycholate). These compounds stimulate dermal fibroblast activity, increase collagen synthesis, reduce oxidative stress, and improve local microcirculation. A study published in 2021 histopathologically confirmed that mesotherapy plays a fundamental role in the regeneration of the dermal matrix. In addition to manual injection, mesotherapy can also be applied using automatic mesotherapy guns or needle-free methods (electroporation). In manual technique, nappage (superficial multiple injections), papule (small intradermal bubbles), or deep point injections are preferred. Automatic guns offer homogeneous application by providing control over depth and dosage. Local anesthetic creams are used during application to minimize pain. Needle-free methods are less invasive but have limited penetration of active substances. A 2024 study reported that needle-based mesotherapy was superior in terms of dermal penetration and effectiveness.
Skin Rejuvenation and Anti-Aging Applications
Mesotherapy is frequently preferred for skin rejuvenation. It is effective in treating fine wrinkles caused by photoaging and chronological aging. Substances such as hyaluronic acid, vitamin C, and amino acids stimulate collagen and elastin production, increasing skin elasticity and dermal hydration. It also strengthens the epidermal barrier function. A 2021 study showed that six sessions of facial mesotherapy increased skin elasticity by 25% and reduced wrinkle depth by 18%. Histological analyses confirmed an increase in collagen types I and III.
Hair Loss Treatment
Hair mesotherapy is an effective method for the treatment of alopecia (hair loss). Substances such as vitamins (e.g., biotin), D-panthenol, minoxidil, and growth factors are injected into the hair roots to extend the follicular anagen phase and shorten the telogen phase. A randomized controlled study published in 2020 showed that hair mesotherapy increased hair diameter by 15% and reduced hair loss by 30%, improving the ratio of terminal hair.
Cellulite and Local Fat Reduction (Lipolysis)
Mesotherapy is used in the treatment of cellulite and reduction of localized fat accumulations. Lipolytic agents (e.g., phosphatidylcholine, sodium deoxycholate) are injected to promote the breakdown of fat cells (lipolysis). In cellulite treatment, substances that increase microcirculation and reduce fibrotic bands are used. A study published in 2019 reported that eight sessions of cellulite mesotherapy reduced skin irregularity by 32% in ultrasonographic measurements and increased patient satisfaction to 85%.
Pain Management and Musculoskeletal Disorders
Therapeutic applications of mesotherapy also include chronic pain management. Especially in conditions such as osteoarthritis and fibromyalgia, analgesic and anti-inflammatory substances are applied locally. A study published in 2022 showed that mesotherapy reduced pain and improved function in knee osteoarthritis.
Skin Spots and Pigmentation Treatment
Mesotherapy is also effective in treating skin pigmentation issues such as hyperpigmentation and melasma. Antioxidants such as vitamin C, tranexamic acid, and glutathione suppress tyrosinase enzyme activity, reducing pigmentation and evening skin tone by inhibiting melanin production. A clinical study conducted in 2020 reported that five sessions of mesotherapy reduced the MASI (Melasma Area and Severity Index) score in melasma by 40% and evened out skin tone.
Benefits of Mesotherapy: Fast and Local Effect
The greatest advantage of mesotherapy is the direct delivery of active substances to the target area. This provides fast and effective results without entering systemic circulation. Furthermore, the use of low-dose medication reduces the risk of side effects. A review published in 2023 reported that mesotherapy provided 90% efficacy in skin renewal, 85% in hair treatment, and 75% in cellulite treatment, with high patient satisfaction.
Side Effects of Mesotherapy: Common and Rare
Although mesotherapy is generally considered safe, some side effects have been reported. Common side effects include redness, swelling, and bruising at the injection site, which usually resolve within 1–3 days. In rare cases, infections, allergic reactions, or granuloma formation may occur. A 2021 case study emphasized that infection risk increases in procedures performed under non-sterile conditions. To minimize these risks, antiseptic protocols and standardized cocktails should be followed.
Suitability and Contraindications for Mesotherapy
Mesotherapy can be applied to healthy individuals over the age of 18. However, it is contraindicated in cases of pregnancy, breastfeeding, clotting disorders, active skin infections (herpes, impetigo), keloid tendency, autoimmune diseases, and in patients receiving immunosuppressive therapy. A guideline published in 2023 also emphasized that bleeding diathesis and autoimmune skin disorders (such as lupus and scleroderma) should be carefully considered.
Post-Mesotherapy Care and Recommendations
For the first 24–48 hours after the treatment, it is important to avoid sun exposure, contact with hot water, and the use of makeup. The use of moisturizers and barrier-repair creams (e.g., those containing zinc oxide) is recommended, along with increased water intake. A study conducted in 2022 showed that proper post-procedure care reduced the risk of inflammation and hyperpigmentation by 50%.
Conclusion
Mesotherapy is an effective and minimally invasive method with a wide range of aesthetic and therapeutic applications. The benefits it offers in areas such as skin rejuvenation, hair loss, cellulite treatment, lipolysis, and pain management are supported by recent studies. However, sterile conditions and professional application are critically important to minimize side effects. With proper patient selection and appropriate techniques, mesotherapy continues to be a powerful tool in the field of medical aesthetics.
Lee S, et al. Lipolytic Mesotherapy for Cellulite: Ultrasonographic and Clinical Outcomes." Journal of Cosmetic Dermatology (2019).
Kumar V, et al. "Efficacy of Mesotherapy in Androgenetic Alopecia: A Randomized Controlled Trial." Dermatologic Surgery (2020).
Torres R, et al. "Tranexamic Acid Mesotherapy for Melasma: A Clinical and Histological Study." Journal of Clinical and Aesthetic Dermatology (2020).
Bianchi F, et al. "Facial Mesotherapy with Hyaluronic Acid: Histopathological Evidence of Collagen Synthesis" Aesthetic Surgery Journal (2021).
Gupta M, et al. "Complications of Mesotherapy: A Case Series on Infection and Necrosis." Dermatologic Therapy (2021).
Silva J, et al. "Post-Mesotherapy Care: Impact on Inflammation and Pigmentation Risk." Clinical, Cosmetic and Investigational Dermatology (2022).
Zhang L, et al. "Systematic Review of Mesotherapy Efficacy in Aesthetic Dermatology." Journal of Dermatological Science (2023).
Khan A, et al. "Patient Selection and Safety Guidelines for Mesotherapy in Dermatology." Dermatology Practical & Conceptual (2023).
Park H, et al. "Needle vs. Needle-Free Mesotherapy: A Comparative Study on Penetration and Efficacy." International Journal of Dermatology (2024).
Rossi G, et al. "Nanotechnology-Enhanced Mesotherapy: Future Directions in Dermatologic Applications." Journal of Investigative Dermatology (2024).
