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Mesotherapy is a minimally invasive technique that consists of the intradermal injection of variable mixtures of natural plant extracts, homeopathic agents, pharmaceuticals, vitamins, enzymes, hormones and other bioactive substances in microscopic quantities. Mesotherapy was first described by Frenchman Dr. Michel Pistor in 1952. He
first administered procaine intravenously to treat an asthmatic patient and found that the patient’s hear loss was treated. Then he started to experiment on intradermal injections of procaine for various indications and named the method as “mesotherapy” in 1976. The use of mesotherapy, whether scientifically proven or not, has been outspreading over 50 years [1,2,3]

The term mesotherapy means the treatment of the mesoderm, which is one of the three primary germ layers in the early embryo that develops into connective tissue, muscle and the circulatory system. Mesotherapy is used in the treatment of cellulite, local fat deposits – xanthelasma, lipoma, alopecia, rejuvenation – wrinkles, skin tightening, hyperpigmentation and melasma, body contouring and scar reduction. Compounds used in mesotherapy applications are lidocaine, procaine, xylocaine for local anesthetics; NaCl 0.9 % for diluents; MgSO₄, pantothenic acid, biotin, cobalamin, B complex vitamins, vitamin B12, vitamin C, vitamin A, zinc, selenium for minerals and vitamins. The main substance of mesotherapy is procaine [2,4,5]. Mesotherapy has been used for several years in Europe and South America for body contouring. Its introduction and application is about 10-15 years in Turkey. Mesotherapy describes a technique by which mixtures of medications and other compounds are injected directly into a diseased area so that systemic effects of oral or intravenous medications can be avoided. The composition of common mesotherapy formulations is selected and mixed in a ‘‘cocktail’’ before injection [3]. A lot of substances can be added such as piroxicam for the antiinflammation effect, pentoxyphylline for circulation stimulation, tretinoin for the collagen regeneration, finasterid, dutasterid, biotin and minoxidil for hair growing, aminophilin, cafein and phosphatidylcholine for lipolysis. There is no standardized formulation for mesotherapy and ingredients vary depending on indications. The components and combination of injected material is based on anecdotal reports or the physician’s experience [5,6]. There are no clinical data that have been published that include standardized regimens, treatment protocols. The science of mesotherapy can be advanced only by scientific and clinical research [7,8] (Table 1 and 2).

Zekayi Kutlubay* and Özge Karakuş

Cerrahpaşa Medical Faculty, Department of Dermatology, Istanbul University, Istanbul, Turkey