The ins and outs of mesotherapy

mesotherapy The ins and outs of

We asked DR MARISA HEYNS to give the low-down on mesotherapy, its specific applications as opposed to micro-needling, and who should be performing it.

Please define the term mesotherapy. Mesotherapy is a procedure involving multiple superficial injections of active ingredients into the dermal layer of the skin. Aesthetic mesotherapy focuses on the introduction of actives such as vitamins, minerals, growth factors, hyaluronic acid, amino acids etc. that play a role in regenerating and rejuvenating the skin. The objective is to nourish, hydrate and stimulate the dermis to upregulate its own regenerative processes, as opposed to breaking the skin down in order for it to renew itself.

Who first conceived of mesotherapy and when? The term mesotherapy was coined in 1952 by a French medical physician, Dr Michel Pistor, who found that injecting small amounts of pharmaceutical actives into the dermal layer of the skin could lead to the symptomatic relief of various medical conditions, such as pain and vascular disorders.

How does mesotherapy differ from micro-needling in terms of its function and effect on the skin? Mesotherapy focuses on the principle of introducing active ingredients into the skin that can activate a regenerative process within the skin, without the need to damage or activate a wounding cascade to initiate

When one is actively breaking down the skin barrier using micro-needling, laser or radiofrequency treatments, one has to use mesotherapy to help rebuild and promote healthy skin regeneration.

inflammation and skin renewal. Micro-needling involves a form of mechanical damage (superficial or deep) to the skin, with or without the use of active ingredients to initiate a cascade of inflammation, wound healing and skin remodeling.

In what instances would you suggest a patient have mesotherapy as opposed to micro-needling? As mentioned, mesotherapy is a truly nutritive treatment, meaning its aim is to feed the skin with ingredients to boost its structure, moisture and elasticity and inevitably improving its function. I would suggest the use of mesotherapy as a build-up treatment in skin where there is a lack of hydration and nourishment. Ideally, any ‘break-down’ treatment whether it is a chemical peel, microneedling, laser or radiofrequency, should be preceded or followed by a mesotherapy session. This will allow for optimal skin treatment results.

Are there any skincare applications for mesotherapy other than anti-ageing? Absolutely! Mesotherapy can be used as part of hair loss treatments, hyperpigmentation disorders, scar and stretch mark treatments, and even for the treatment of cellulite, excess fat, and fluid retention

What qualifications are necessary to perform a mesotherapy treatment? In South Africa, at the moment, according to the Health Professions Council – mesotherapy can only be performed by medical professionals, as it involves the injection of substances into and organ of the body (i.e the skin).

What is transdermal mesotherapy? Transdermal refers to passing active ingredients deep into the epidermis without the use of needles. This can be achieved by iontophoresis (using the positive and negative charges on molecules to transfuse ingredients into the skin, or sonophoresis (using ultrasound) to move actives into the skin.

Can mesotherapy be used in combination with other treatments? In my opinion, it is a must. When one is actively breaking down the skin barrier using micro-needling, laser or radiofrequency treatments, one has to use mesotherapy to help rebuild and promote healthy skin regeneration.

Are there any instances where one would choose a syringe as opposed to an injector gun, or are they much of a muchness? Personally, I prefer using a syringe as I can precisely control the depth of the needle insertion, especially over delicate areas like the periorbital regions, to avoid excessive pain and bruising. Some practitioners prefer mesoguns purely because it takes less time to perform a treatment.

What sort of mesotherapy cocktails are there in terms of ingredients, specifically for an anti-ageing application? There are a variety of active ingredients that are safe and effective in treating ageing skin. One has to ask: ‘What does this skin need to look and feel younger?’ To improve structure and collagen production, one may need organic silicone or peptides. To hydrate and plump, we need hyaluronic acid, or to brighten and protect, we might need antioxidants such as Vitamin C. Always stick to using an active ingredient in its most sterile and purest form.

For anti-ageing mesotherapy, how many treatments would you prescribe, and at what intervals? Ageing unfortunately does not happen overnight! It generally takes the skin three months (just like any other soft tissue structure) to repair itself and show its results. So, I generally recommend three to five sessions, spaced two to four weeks apart.

Do you use a numbing cream prior to a mesotherapy treatment? Generally, I do not, unless my client requests it. The aim with mesotherapy is to remain superficial. If one goes too deep, the chances of bleeding and bruising increases. So if a client is suddenly experiencing worsening discomfort, then I know I need to work more superficially.

What is the downtime with a mesotherapy treatment, particularly if you have sensitive skin? It is considerably less compared to micro-needling. The skin can look a bit red and blotchy for a day (at most two days) and, depending on the injection techniques, one can sometimes have a few spot bruises or bumps that will settle within two to three days. Mesotherapy is especially good for sensitive skin with an impaired barrier that will, under normal circumstances, not tolerate a chemical peel or micro-needling. The important thing is to choose the correct active ingredient to manage the current skin concern.

What are the contra-indications for mesotherapy? The main contraindications include active skin disease (active eczema, acne, psoriasis) or skin infections. I generally stay away from treating clients with auto-immiune disease unless the condition is very well managed, just because the skin can react unpredictably.

If someone is on a mild blood thinner like Ecotrin, is mesotherapy contra-indicated? Generally speaking, if you are on a blood thinner or platelet inhibitor such as aspirin, your chances of bleeding and bruising is much higher. This is not necessarily a contra-indication, but you will have to warn your client that he or she may high have a high risk for bruising, and that traditional mesotherapy might not be the best option for them. PB

Dr Marisa Heyns is a general practitioner who specialises in aesthetic medicine. She obtained her medical degree (MBChB) at the University of Cape Town in 2007, and is one of a handful of doctors in South Africa with a European Masters Degree in Aesthetic Medicine and Therapeutics (UNICAM, Italy). Her scope of practice extends from minimally invasive procedures (botulinum toxin and hyaluronic acid based fillers), to more invasive procedures (Co2 laser, fractional radiofrequency treatments and threads). She also performs mesotherapy (skin boosters) and PRP treatments (Growth factor glow, and O shot).

drheyns@dermafrica.com