Mesotherapy and its application in the fight against baldness


Article on mesotherapy in the fight against baldness, kindly written by Dr. Arrigoni for Dr. Kaan Pekiner..



The term mesotherapy derives from the French mésotherapie and was officially coined for the first time by French physician Michel Pistor (1924-2003) in 1958 in “La Presse Medicale”, in an article that collected his experiences with procaine injections and other drugs.
The name mesotherapy (from the greek mesos = means) refers to the mesoderm, the median embryonic leaflet that gives rise to connective tissues, including the dermis, the site of inoculation of drugs. The mesotherapy or intradermo-district therapy consists in the injection of a drug of the official pharmacopoeia / medical device injectable in the dermis of a well defined topographic area, corresponding to the skin projection of an organ or part of it, site of a pathologic process. Injecting a small dose of drug into the dermis, in correspondence of the area to be treated, a small intradermal deposit of medicine is formed, which, spreading slowly, will interact almost exclusively with local receptors, with prolongation of therapeutic activity until the small deposit is exhausted. The administration of the drug is performed with a series of microinjections in the corresponding skin district. With this method it is possible to achieve therapeutic effects of great effectiveness, significantly greater than those achievable with the systemic administration, using, with regard to the drugs of the official pharmacopoeia, half or one third of the daily dose provided for a cycle of intramuscular injection therapy..



Therefore, mesotherapy is the technique by which we try to bring the medicine close to the pathological process in order to maximize its effectiveness and decrease the side effects. Let’s imagine that we have an acute knee pain and we want to relieve it with an anti-inflammatory. We can take a tablet per os, apply a cream locally or apply mesotherapy on the knee. Practicing it for years, I can say with certainty that the results of the mesotherapy route are incredibly greater, and although there are patients who are sensitive to oral anti-inflammatories, I have never had a side effect regarding the stomach in this case, but neither have I had any other kind.
Given these results, surely the question that arises is why, if so effective, we hear very little about it. In my opinion it is basically a problem of cost (since mesotherapy must be practiced by a doctor), of impracticality for the patient and perhaps in the final analysis, difficult to apply on a large scale. I am of the opinion that if a family doctor started to practice it at low cost, if not free of charge, to his elderly patients full of aches and pains, we would have a big saving for the national health system in terms of drugs and diagnostic tests. The field of greatest use today is in sports medicine (when it is necessary to make an athlete efficient in a short time), and in aesthetic medicine, where substances are injected to improve the skin, cellulite, circulation, etc…



Practicing it for many years to treat different pathologies, I would like to express my opinion regarding its application in trichology. Having ascertained that mesotherapy is an injection technique, we must emphasize that the fundamental element is what is injected, that is, the specific drug or cocktail for the related problem. On the market there are injectable preparations for mesotherapy use specifically for the welfare of the hair. There are those containing vitamins, biotin, zinc, hyaluronic acid designed to provide the bulbs with the nutrients needed to create thicker and brighter hair, others containing biomimetic peptides or the same PRP containing growth factors.
These types of products I find them very useful in cases of seasonal effluvium / chronic effluvium or to thicken existing hair. In the case of alopecia areata the intralesional injection of small amounts of a specific corticosteroid can in a large percentage of patients lead to remission of the disease.



As for the androgenetic alopecia instead, mesotherapy can certainly be an aid, but very limited without the use of conventional therapies.
In the literature we find studies on the effectiveness of minoxidil by mesotherapy vs minoxidil in lotion, finasteride in mesotherapy vs oral and also on dutasteride always by mesotherapy. Although they are studies with low power because they were carried out on a small sample of patients, they still give us an indication of effectiveness for all three types of treatment and especially without the onset of side effects. Delving into the first study, that of minoxidil, injections every 15 days gave equal if not greater results on the diameter than the lotion. If we think that the half-life of the drug is less than 24 hours is really to think that the mesotherapy in some way lengthens the half-life of the drug (sorry for the bestiality of scientific terminology). Having the dutasteride a half-life for os of about 5 weeks does not surprise us that it can be administered by mesotherapy at intervals of three months still being effective.
Also by mesotherapy there are galenic compounds for injectable use containing drugs whose efficacy has been documented by scientific studies, for example minoxidil associated with bitamoprost.



That said, I would like to express my personal thoughts on these “new” therapies.
The task of the doctor is to help the patient to feel better, to heal thanks to the instruments in his possession with the first requirement not to harm, not to do damage. The doctor as well as the painter who has a palette of colors to make his painting, has a series of tools, medicines at his disposal to help the patient and the greater these resources will be for both figures the greater will be the possibility to customize the work, the therapy, in principle the result. Surely they will have to deepen with more impactful studies the potential of mesotherapy, in the meantime I believe that combining science with empiricism, that is the experience of the doctor can certainly lead to very rewarding results. Each patient is unique and responds to treatment differently. I see mesotherapy very well for those who want to try to increase the results achieved with conventional therapies or for those patients who do not want or can not take it for the onset of side effects.


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