Mesotherapy: mechanism of action, technique, indications and contraindications

Mesotherapy is the injection of biologically active substances into the dermis. Multiple microinjections are performed locally in the problem zone at the border of the papillary and reticular layers of the dermis. This technique has a large number of indications and uses.

Indications for mesotherapy

The main indications for mesotherapy are:

• restoration of lost skin tone and elasticity;
• correction of the face oval, solution of the problem of "double nodborok."
• alignment and improvement of complexion (for hyperpigmentation of different origin, "earthy" color of the face of smokers and people living in regions with an unfavorable ecological situation);
• prevention of premature skin aging.

In addition, this method can be used to normalize the activity of the sebaceous glands and reduce the porosity of the skin, restore normal hydration, correct hypertrichosis, prevent the appearance and elimination of telangiectasias, xantelasm, and also as part of the comprehensive treatment of hypertrophic scars, acne, rosacea, multiple warts and fibroids (papillomas).

Contraindications to mesotherapy

Mesotherapy is contraindicated in disorders of blood clotting (primarily hemophilia), pregnancy and lactation, hypertension II-III stage. Intradermal injections should not be performed with such infectious diseases of the skin as herpetic infection, pyoderma, tuberculosis, etc. Such a small number of contraindications is due to the fact that mesotherapy is a method that allows to take into account the individual characteristics of each patient, the presence of any diseases or allergic reactions and pick up those drugs that are right for him. In addition, in the process of treatment, it is possible to take into account the changes that occur or the slow dynamics of the process and to change the composition of the injected cocktails or the technique of administering the preparations.

Techniques for performing mesotherapy

They use classical injections, nappage techniques, retrograde injections, infiltration.

Classical injections - the method of administration, which ensures maximum effectiveness of the procedure and the most prolonged deposition of drugs. The depth of needle insertion when injecting drugs into the skin of the face should be 1 -2 mm, in the eyelids, on the neck, in the decollete - no more than 1 mm. The distance between the injection points is from 0.5 to 1 cm. The amount of the drug injected into each point is from 0.01 to 0.03 ml. The angle of introduction is from 45 to 60 °.

Nappage is another option for administering drugs with mesotherapy. In this case, injections are made at a minimum distance from each other (2-3 mm), rather superficially and quickly. Depending on the depth of administration, surface, middle and deep nappage are isolated. The maximum involvement and activation of the skin's receptor apparatus occurs, the skin is minimally injured, but a significant drawback of this technique is a large loss of injectable drugs (up to 50%).

Retrograde injections are the administration of the drug as it is removed. In this case, the needle is inserted parallel to the skin. In this way, a controlled destruction of wrinkles and "reinforcement" is carried out.

Infiltration is the administration of drugs to a depth of more than 4 mm. As a rule, the volume of injected drugs is increased to 0.1 ml. The degree of deposition of drugs in this case is significantly reduced, they quickly fall into the bloodstream. On the facial skin, infiltration is used to correct the face oval, the "double chin". Injections can be performed by a conventional syringe manually and using special devices that facilitate the rapid introduction of funds into a large number of points simultaneously (injectors, pistols). For mesotherapy, various types of injectors can be used - DHN, Pistor, etc. The choice of method of administration depends on anatomical localization, indications and injection technique. When carrying out the procedure of mesolifting a combination of hardware and manual methods is used. When applied to the skin in the lower eyelid, neck, as well as during controlled destruction of wrinkles, manual methods are used. In this case, syringes with 30G or 32G needles 4 to 13 mm in length are used. You can also use the SIT needle (a needle located in the center of the cone-shaped clutch - stop). It makes it possible to produce the most comfortable procedure for the patient with minimal pain and trauma. Classic injections can be performed either manually or using a gun. The use of the injector is most convenient when performing the alignment to ensure maximum speed and painlessness of the procedure.

Intradermally injected as traditional medicines (anesthetics, vasodilators, lympho- and venotonicks, vitamins and trace elements, enzymes, anti-inflammatory and antibacterial drugs, antiandrogens, etc.), as well as complex homeopathic and antihomotoxic drugs. Given the fact that drugs injected into the upper third of the dermis by multiple microinjections are deposited and remain in the zone of administration for 6 to 10 days, the recommended frequency of mesotherapy sessions is once every 7-10 days. In the event that drugs of prolonged action are used, it is possible to make a longer break between sessions (up to 2-3 weeks). In the event that homeopathic preparations are used, the recommended frequency of sessions is three times a week.

Mesotherapy is prescribed for the prevention of premature skin aging in patients starting at age 26. At this age, mesotherapy is especially relevant in individuals with dry and dehydrated skin. As is known, levels of hyaluronic acid and chondroitin sulfate are determinants of maintaining the skin's water balance and creating favorable conditions for synthesis and distribution in the intercellular matrix of collagen and elastin. With age, the amount of hyaluronic acid decreases significantly, which is one of the reasons for the appearance of signs of skin aging. However, in some patients, the amount of hyaluronic acid insufficient for metabolic processes is detected already at a young age and should be replenished as soon as possible. To this end, it is recommended to administer stabilized hyaluronic acid preparations with prolonged action at a frequency of once every 2 months. A good effect is also a combination of these injections with the introduction of vitamins and trace elements. Injections of hyaluronic acid (IAL-SYSTEM, Restylane vital or AcHyal) can be optimally produced after anesthesia with the use of Emla cream occlusion in the technique of classical injections. And Restylane vital is recommended to enter to a deeper level, without the formation of papules. This drug, unlike IAL-SYSTEM and AcHyal, is not injected into the periorbital area, but it is great for strengthening contours, oval face and creating a longer hydro-reserve. AcHyal vitamin cocktails can be administered using median or superficial nappazh technique and separate classical injections to ensure full drug deposition.

In younger people (from 18-20 years old), intradermal injections are used to solve seborrheic problems with a tendency to acne. To this end, various microelements (Zn, Co, Si, Se) and vitamins (A, E, C, B) and some complex preparations regulating the activity of the sebaceous glands are introduced. Recommended frequency of sessions is once a month, women are recommended to perform them in the middle of the menstrual cycle. The technique is median or deep nappage, classical injections.

With multiple vulgar and flat warts, as well as with relapsing simple herpes (it is mandatory in the inter-recessive period to use ribomunyl, a drug that stimulates both cellular and humoral immunity.) To treat warts, bleomycin and cycloferon are used.

From the age of 28-30, the first signs of aging of the skin in the periorbital region usually begin to appear, the first manifestations of gravitational ptosis of the soft tissues of the face and neck (deepening of nasolabial folds, the appearance of excess skin in the chin region) are possible. In this case, the alternation of the introduction of embryonic extracts (mesenchyme or embryoblast), common in European countries (4-5 sessions once every 7-10 days), with the introduction of stabilized hyaluronic acid (IAL-SYSTEM or AcHyal 2-3 sessions one every two weeks or Restylane vital 2-3 sessions once a month). In the future it is recommended to carry out supporting procedures once every two to three months (one procedure using hyaluronic acid, and one week later - one procedure with embryonic extracts or vitamins and microelements). After 35-40 years, the course can be increased to 6-10 sessions using embryonic extracts (once a week) and up to 3-4 sessions with IAL-SYSTEM or AcHyal, and the interval between procedures should be reduced to 10 days. Supportive procedures should be done once a month. You can use homeopathic and antihomotoxic drugs, for example, the German firm Heel. In this case, the course will consist of 10-15 procedures, which are conducted with shorter intervals (once every three days).

Mesotherapy can be carried out in combination with various hardware procedures. In this case, they are carried out before intradermal injections (the same day or the day before). After mesotherapy, it is undesirable to use any procedure with lymphodrainage effect (for example, microcurrent therapy) for 3-4 days to avoid reduction of the term deposited the drugs administered. Good results also give the use of mesotherapy in the pre- and postoperative period during plastic surgery, chemical and laser resurfacing.

Side effects of mesotherapy

Side effects include soreness at the time of injection, erythema, hemorrhagic spots.

Painful sensations during the procedure can vary in different patients. The degree of soreness depends on the individual threshold of pain sensitivity, the state of the nervous system at the time of the procedure, and also on the injection technique and medications used. To reduce soreness, you can apply an anesthetic cream (for example, Emla), which is applied to the skin in a thin layer for 15-20 minutes before the procedure.

Short erythema (about 30-60 minutes) is a natural consequence of increased circulation and may be more pronounced after the administration of vasodilators and vitamins. It should not cause any concern. If erythema remains after a mesotherapy session, then you should think about changing the composition of the injected cocktails and about the advisability of using this technique in this patient. You should also be wary of the possibility of the appearance of allergic reactions starting with erythema, and conduct appropriate differential diagnosis, and if necessary, desensitizing therapy.

Hemorrhagic spots (petechiae and ecchymosis) can appear in patients with reduced blood coagulability or with a violation of the elasticity of the capillary wall. Also, the risk of their occurrence is high enough when using the technique of controlled destruction of wrinkles or with a deep introduction of the needle (deep nappage, infiltration). Any procedures or preparations for their resorption should be applied locally, in the hemorrhagic spot area.

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