Mesotherapy: What Is It, What Is It Used For, and What Does the Evidence Say?

What is mesotherapy and how does it work?

Mesotherapy is a method based on injecting many small amounts of a substance into the skin with fine needles. It can be done by hand with a syringe or with devices developed for this purpose. The aim is for the substance to act directly in the targeted area.

The contents used are very diverse: hyaluronic acid, vitamins, amino acids, plant extracts, some active drug ingredients, or mixtures of these (popularly called “cocktails”). There is no common, standard protocol for content, dose, depth or number of sessions. This makes it difficult to compare the results of different studies.

Part of the effect of mesotherapy may also be related to the mild stimulation that the needle pricks themselves create in the skin. It is often unclear which effect is due to the substance applied and which is due to the procedure itself.

What is it used for, and what does the evidence say?

Mesotherapy is used for very different purposes, but the scientific support is not the same for each. The summary below is a general framework; the product content and the way it is applied can significantly affect the result.

• Skin quality (hydration, radiance, fine lines): improvement has been reported in some studies; however, most studies are small and short, and the evidence is limited.
• Hair loss: it has been tried with different contents in some types of hair loss. The evidence is limited and variable; where the content includes an active drug ingredient, the possibility of side effects must also be considered. The cause of hair loss should be investigated first.
• Local slimming, cellulite and “fat dissolving”: reliable evidence for these claims is insufficient. Serious side effects have also been reported with injections targeting fat tissue. This use is not a weight-loss method.
• Other purposes such as pigmentation and dark circles under the eyes: the evidence is limited; an examination is needed to determine the cause and the appropriate treatment.

Platelet-rich plasma (PRP) treatments are sometimes also referred to under the heading of mesotherapy; however, it is a different procedure and is covered in a separate guide.

Who might it suit?

It may be considered for adults with mild changes in skin quality who know the result may be limited and temporary and who accept a process of several sessions. With hair loss, the cause (such as hormonal, nutritional, thyroid or stress-related) should be investigated first; mesotherapy alone does not replace a diagnosis or treatment plan.

Who is it not suitable for, and what should you watch out for?

• Pregnancy and breastfeeding
• Active infection, cold sores, an eczema flare or an open wound in the treatment area
• A history of allergy to any of the ingredients
• Use of blood-thinning medicines or a bleeding disorder (do not stop your medicine on your own; talk to your doctor)
• An undiagnosed skin lesion or undiagnosed hair loss

This list is not complete; tell your doctor about all your health conditions and the medicines you take.

Who should perform it, and where?

Mesotherapy is an injection procedure. It should be performed after a doctor's examination, following sterile conditions. In Turkey, these matters are regulated by the Ministry of Health; the procedure must be performed by a doctor in a licensed healthcare facility. The person performing it must be able to recognise and manage possible side effects.

The medical literature reports skin infections, whose treatment can take months, after treatments carried out in non-sterile conditions or with unsuitable products. Injections given at home, in beauty salons or with products of uncertain origin carry serious risk in this respect.

About “cocktails” of unknown content

One of the most important safety problems with mesotherapy is not knowing what is being injected into you. Mixtures without an ingredient list, unlabelled, of uncertain import origin or bought online carry risks of allergy, infection and tissue damage.

• Ask for the name, contents and licensing status of the product to be used.
• Ask for the product to be opened in front of you from its sealed, original packaging.
• Do not accept a mixture whose contents are not disclosed and are described as a “special formula” or “secret”.
• Keep a record of the product used; this is important for your doctor if a problem arises later.

Preparing for the procedure

• At the examination, share your expectations, your medical history and the medicines and supplements you take in full.
• Do not stop your prescribed medicines unless your doctor advises it; discuss medicines and supplements that may increase the risk of bruising with your doctor.
• If you have a history of cold sores, mention it, especially before facial treatments.
• On the day of the procedure, the treatment area should be clean and free of make-up and products.
• Get clear information in advance about the number of sessions, their spacing and the overall process.

The procedure day, step by step

1. The doctor assesses the area and shares the content to be used and the plan with you.
2. If needed, a numbing cream is applied and left for a while.
3. The skin is carefully cleaned with an antiseptic solution; this step is important to reduce the risk of infection.
4. The product is applied with fine needles to many small points, or with the help of a device.
5. After the treatment the area is cleaned; small bleeding points stop quickly.
6. You are given aftercare advice, the date of the next session and information on how to get in touch if there is a problem.

After the procedure: the first 24 hours and the first week

In the first hours there may be redness, small bumps or pinpoint swellings in the area. It is generally advised not to touch the area and not to use make-up or heavy skincare products for as long as your doctor recommends. For scalp treatments, follow your doctor's advice on when to wash your hair.

You may be asked to avoid saunas, Turkish baths (hammam), swimming pools and intense exercise in the first days. If you go out in the sun, sun protection is important.

Expected side effects

• Redness and mild swelling
• Small bruises at the injection points
• A brief burning or stinging sensation during and after the treatment
• Mild itching
• Swelling on the face, especially around the eyes, lasting a few days

These symptoms usually settle within a few days. Steadily increasing pain, redness or discharge is outside the expected course.

If you cannot reach your doctor, go to an emergency department. Unless your doctor advises it, do not massage the area or apply heat or ice, and do not take medicines on your own.

Some infections and reactions such as granulomas (inflammatory tissue the body forms in response to a foreign substance) can appear weeks after the procedure. For this reason, knowing the product used and the date is very valuable for any doctor you see later.

When are results seen, and how long do they last?

With skin treatments, some people may notice a more hydrated appearance after the first sessions; however, assessment is usually made after the series is completed. With hair treatments, any change can be assessed over months because of the hair's natural growth cycle.

Even where there are effects, they are temporary. How long they last varies by content, method of application and person; it is difficult to give a reliable, generalisable duration.

Realistic expectations: what mesotherapy cannot do

• It cannot lift sagging skin and does not correct pronounced wrinkles.
• It is not a method for weight loss or local slimming.
• It does not remove the cause of hair loss; treatment without investigating the underlying cause can waste time.
• Results vary greatly from person to person; some people may see no noticeable change.
• It does not replace a healthy lifestyle, sun protection and appropriate skincare.

Alternatives

This page is for general information only. The method that suits you can only be determined through an examination and a doctor's assessment.