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Cosmetic procedures for antiaging carry inherent risks of adverse events. One that has not yet been well characterized is transitory or permanent alopecia. This is attributable to numerous mechanisms including pressure, ischemia, inflammation, and necrosis. Cases of postcosmetic procedure alopecia have been reported after mesotherapy as well as hyaluronic acid filler, deoxycholic acid, and botulinum toxin injections.This review serves to describe the currently known causes of postcosmetic procedure alopecia and the mechanisms by which alopecia is attained. Furthermore, this review highlights the risk of unregulated mesotherapy injections for cosmetic enhancement and to bring attention to the increasing number reports of alopecia after these procedures.A systematic review of the literature from 2000 to 2022 was conducted looking for keywords such as "alopecia," "cosmetic procedures," "mesotherapy," and "hyaluronic acid" in Google Scholar and PubMed.Ten articles met the criteria set forth in the authors' literature review. Many of the procedures resulted in partial or complete resolution of alopecia.Alopecia after cosmetic injection procedures is an underreported adverse effect. More research is needed to further characterize the risk of alopecia after mesotherapy and other injection procedures.

OBJECTIVES Melasma is a chronic acquired condition characterized by grayish-brown macules and patches with a distinct border on the face. Although various treatments methods have been suggested for treating melasma, none has been completely successful. The aim of the study was to compare the efficiency of erbium: yttrium-aluminum-garnet (Er:YAG) laser and 4% hydroquinone (HQ) with the effects of intradermal tranexamic acid (TA) and 4% HQ for the treatment of refractory melasma. METHODS The study included 31 female patients with refractory melasma. The left or right side of the patient's face was chosen randomly to receive laser therapy with topical HQ on the one side (i.e., the laser side) and intradermal injection of TA plus topical HQ on the other side (i.e., the mesotherapy side). Digital photography was performed at baseline, at the end of the treatment, and three months after the treatment as follow-up. Two independent dermatologists evaluated the modified Melasma Area and Severity Index (mMASI) score according to the pictures. Overall, 27 patients completed the study and went through the clinical evaluation. RESULTS Treatment using HQ in combination with either Er:YAG laser therapy or intradermal injection of TA significantly improved the hemi-mMASI and resulted in higher patient satisfaction. While the improvement was not significantly different between the two regiments after the treatment and upon follow up and both were equally efficient in the treatment of refractory melasma (p = 1.308), recurrence rate was higher after treatment with Er:YAG laser than TA (12% vs 34%). CONCLUSION This study confirmed the comparable efficacy of TA plus topical HQ versus Er:YAG laser plus topical HQ for the treatment of refractory melasma. Both groups improved significantly and no subject left the treatment because of adverse effects.

Alopecia as a disease condition can be a symptom of other ailments, the body’s reaction to medications, hormonal changes, nutritional deficiencies, hygiene negligence, too intense or frequent cosmetic procedures, or it can constitute an independent disease syndrome. Depending on the individual genetic traits, alopecia may also be inherited. Usually, there is no one universal cause for this disease to occur. Properly conducted diagnosis of the problem and individually selected therapeutic substances can help to deal with this problem or at least delay hair loss associated with the physiological aging process. One of the treatments that are used to support the treatment or prevention of alopecia is needle mesotherapy. It is a local treatment that delivers healing substances having stimulating, regenerating, and nourishing effects directly to the skin or hair follicles. The medicinal substances administered during the needle mesotherapy treatment include peptides, biotin, minoxidil, d-panthenol, vitamins, and minerals, alone or in the form of mixtures, as well as platelet-rich plasma and stem cells. The effects of needle mesotherapy in alopecia are visible after a single treatment when hair loss stops. On the other hand, the thickening and regrowth of new hair are visible after a series of treatments. The full course of therapy depends on the type of alopecia, a patient’s condition, and its comorbidities. It usually consists of four to eight treatments performed at two-week intervals. In the case of alopecia, they are visible after two months, and to maintain the effect, a reminder treatment is recommended after six months. Not all people can undergo such a procedure. The main contraindications include: (1) pregnant and lactating women; (2) children and persons under the age of 18; (3) people who are allergic to any of the ingredients of the administered preparation; (4) people with skin lesions, skin diseases, active infections (bacterial, viral, fungal) or susceptibility to streptococcal infections (recurrent strep throat); (5) people taking drugs: immunosuppressants, anticoagulants, non-steroidal anti-inflammatory drugs, high doses of glucocorticosteroids; (6) patients with decompensated diabetes, neoplastic, mental, rheumatic diseases, or other autoimmune disorders. Needle mesotherapy is very popular in cosmetology and aesthetic medicine clinics. This innovative method is a proven and relatively safe procedure in the fight against various skin conditions, including alopecia. Keywords: excessive hair loss, alopecia, needle mesotherapy, platelet-rich plasma, biomimetic peptides, stem cells.

Background Androgenetic alopecia (AGA) is the most common form of alopecia in men, affecting 70% by the age of 20 years. The present study was conducted with the objective of comparing the efficacy of monotherapy with topical 5% minoxidil and its combination with intradermal platelet rich plasma (PRP), in male AGA. Methods This observational study was conducted at the dermatology department of a tertiary care hospital over a duration of 2 years. 100 patients with AGA were selected and divided randomly into 2 treatment arms: Group A (MM): received topical 5% Minoxidil monotherapy for 12 months and; Group B (M + PRP): received combination therapy of PRP and topical 5% Minoxidil for 12 months. The following parameters were subsequently analyzed on follow up: Physician-assessed global photography by a 4-point improvement scale and trichoscopic improvement of mean hair diameter. Results The combination was statistically superior to the monotherapy group in promoting hair growth in men with AGA for both measures of hair growth – photographic assessment and trichoscopic mean diameter. Conclusion We hereby conclude that intradermal PRP injections should be offered to all patients with AGA along with the existing therapeutic modalities, for faster hair regrowth and improved compliance.

BACKGROUND:Migraine is a prevalent disabling primary headache disorder that is classified into two major types: migraine without aura and migraine with aura. New therapeutic methods to reduce migraine headaches in the emergency department (ED) include intradermal mesotherapy.OBJECTIVE:Compare the efficacy of intradermal mesotherapy versus a systemic therapy in pain control in patients with headache related to migraine without aura.DESIGN:Prospective parallel-group randomized controlled trial.SETTING:University hospital in Turkey.PATIENTS AND METHODS:Patients 18 years of age and older who were admitted to the ED over a 15-month period with headache related to migraine without aura were eligible for inclusion if they had a VAS score of 4 or above. Patients were randomly allocated to one session of mesotherapy or intravenous dexketoprofen. Changes in pain intensity were measured by the score on a visual analog scale (VAS) at 30, 60, and 120 minutes and 24 hours after treatment. Efficacy was also assessed by the need for use of an analgesic drug within 24 hours, by readmission with the same complaint to the ED within 72 hours, and by adverse effect rates.MAIN OUTCOME MEASURE:Pain intensity on the VAS scale.SAMPLE SIZE:148 patients (154 enrolled and treated; 1 patient in the mesotherapy and 5 patients in the systemic therapy group lost to follow up).RESULTS:Pain intensity on the VAS scale decreased from a median score of 8 to 4 in the mesotherapy group and from 8 to 5 in the systemic therapy group. These differences were statistically significant from baseline for all time intervals (P=.001 to 30 minutes,P=.004 to 60 minutes,P=.005 to 120 minutes, andP=.002 to 24 hours). The need to use analgesics and the rate of readmission to the ED were higher in the systemic therapy group (P=.013 andP=.030, respectively). Adverse effect rates were minimal and similar in the study groups during the one-week follow-up period.CONCLUSIONS:Mesotherapy is more efficacious than intravenous dexketoprofen in the management of acute attack of migraine without aura in the ED.LIMITATIONS:Unblinded. Valid for assessing short-term pain relief, but not sufficient to predict long-term efficacy. Not generalizable because single center and small sample size.CONFLICT OF INTEREST:None.REGISTRATION:ClinicalTrials.gov(NCT04519346)

Background Treatment options for erythematotelangiectatic rosacea (ETR) are still scarce. Tranexamic acid (TXA) is an antifibrinolytic drug that was recently used for the treatment of ETR. Aims to evaluate the efficacy and safety of intradermal microinjections of TXA for ETR. Patients/methods This was a retrospective study enrolling patients, treated with TXA intradermal microinjections for ETR, from January 2019 to February 2020. Response to treatment was assessed based on subjective symptoms, clinical photographs and the Investigator Global Assessment of Rosacea Severity Score (IGA-RSS). Results Six patients were included. The mean number of monthly intradermal TXA microinjections was 5.1±1.3. The mean decrease of IGA-RSS was 2.4±0.5. Local side effects, mainly transient erythema and swelling, were noticed in three cases. No systemic effects were noted. Clinical improvement, in respondent patients, lasted after 3 months of follow-up. Conclusion Intradermal TXA microinjections is a safe and effective treatment option for ETR. The optimal number of monthly sessions has yet to be determined.

Vitamin C/Ascorbic acid inhibits tyrosinase enzyme causing melanin biosynthesis suppression. This study aimed to compare the efficacy of intra-mucosal injection (mesotherapy) with topical gel as non-surgical methods for managing gingival hyperpigmentation. Twenty healthy non-smokers with mild to severe hyperpigmented gingiva were randomly assigned for Mesotherapy (G1); intra-mucosal injection of ascorbic acid (1/week/3 weeks); or Gel (G2), topical ascorbic acid gel (1/day/3 months). Pigmentation index (DOPI), patient satisfaction, as well as histological analysis for Fontana-Masson-stained specimens were performed at baseline and after 6 months. Comparison between groups and changes by time were analyzed using Mann-Whitney and Friedman’s tests, respectively. The median DOPI significantly decreased after 1 month in G1 (P value < 0.001, r = 0.9) compared with non-significant change in G2. No pain experienced during or after treatment in both groups. G1 patients showed significantly higher satisfaction with treatment than G2. Mean area fraction of melanin forming cells was significantly reduced in both groups after 6 months, but the effect size was higher in G1 (r = 0.886) than in G2 (r = 0.797). Vitamin C mesotherapy showed better and early effect than topical gel, and both techniques were not painful and esthetically satisfying in managing gingival hyperpigmentation. Gingival melanin pigmentation causes esthetic concerns for significant number of patients. Investigating non-surgical depigmentation techniques to decrease postoperative complications and patient discomfort, pain and long healing period associated with surgical methods would be clinically significant.

Smooth and even skin possesses a form of magnetism, and people understand it as the external manifestation of a healthy lifestyle. New studies reveal the efficacy of mesotherapy in reducing external signs of ageing, such as wrinkles, large pores, sun damage and loss of glow, elasticity and firmness. The capacity of mesotherapy to stimulate and repair the mechanisms of the skin, creating a suitable environment for the fibroblasts to produce elastin and collagen, offers an effective long-lasting answer to most age-related skin concerns. The full practical aspects needed to perform mesotherapy treatments must be covered in training sessions in person, as the accuracy of mesotherapy depends on many considerations. To practice mesotherapy, practitioners need to have a deep theoretical understanding of the ageing process and of the techniques and materials that are used in mesotherapy.

Introduction Corticosteroid-induced rosacea-like dermatitis (CIRD) is one of the cutaneous side effects of long and excessive application of topical corticosteroids, resembling rosacea that can present with a series of cutaneous manifestations. Most patients with CIRD undergo a variety of long-term treatments before their symptoms are relieved as there is no accepted standard therapy. We gave each of seven patients two sessions of platelet-rich plasma (PRP) mesotherapy before the routine treatment to restore their skin barrier function, and we were surprised to find that the patients’ symptoms and appearance were significantly improved without any further treatments. Here we report this unexpected finding in dealing with CIRD. Case Presentation Seven patients, one male and six female, who had history of applying topical corticosteroids on the face for more than 3 months continuously or intermittently for various reasons were diagnosed with CIRD, showing varying degrees of erythema, telangiectasia, and papules, with dry skin, pain, and burning or stinging sensation. We intended to use the restorative effect of PRP to restore the skin barrier function of the patients for further treatment such as tacrolimus ointment, intense pulsed light (IPL), or pulsed dye laser (PDL), so they were treated twice with PRP intradermal injections using a mesogun injector machine. We used the VISIA skin detector to photograph and compare the changes after the treatments. Clinical efficacy was also assessed by the Global Aesthetic Improvement Scale (GAIS). Patients’ assessments were recorded using three-point scale questionnaires. After two sessions of PRP treatment, before any further treatment, we were surprised to find that the patients' symptoms had improved significantly, as confirmed by VISIA skin detector and GAIS. All of the patients were satisfied with the outcomes, considering that mesotherapy was not painful and their appearance and symptoms had much improved. Conclusions PRP mesotherapy may mitigate sensitivity and inflammation in patients with CIRD by reducing erythema, telangiectasia, and papules. It is worth conducting large randomized controlled trials to verify its safety and efficacy in treating corticosteroid-induced rosacea-like dermatitis and maybe rosacea.

Intradermal injection of autologous platelet-rich plasma (PRP) is a non-surgical cosmetic therapy to rejuvenate the periorbital area pathologies of wrinkles, periorbital hyperpigmentation (POH), and photoaging. The past decade has seen the adoption of this novel therapy around the world. This is the first systematic review and meta-analysis evaluating PRP treatment of periorbital pathologies. This is a PRISMA compliant review that includes a comprehensive search of the databases Cochrane Library, Ovid Medline, Ovid Embase, and clinicaltrials.gov. The search was performed in June 2019 to obtain all peer-reviewed articles published in English that describe the application of PRP to periorbital pathologies. A meta-analysis of patient satisfaction was performed for randomized controlled trials. Nineteen studies treating 455 patients (95% female, age range 28–60) were included. Studies were categorized based on reported outcomes: wrinkles (11 studies), POH (7 studies), and photoaging (6 studies). Patients were treated a mean of 3 times (range 1–8) in mean intervals of 23 days (range 14–56 days). Follow-up averaged 3 months (range 1–6 months). Meta-analysis of 3 randomized controlled clinical trials (RCTs) shows that patients treated with PRP have increased satisfaction above controls of saline, platelet-poor plasma, mesotherapy, and as an adjunct to laser therapy (overall effect p = 0.001, heterogeneity I2 = 64%). PRP treatment of periorbital area pathologies results in histologic improvements of photoaging, subjective satisfaction score increases, and blind evaluator assessments of rejuvenated skin appearance. Future studies are needed to address limitations of the current literature and should include long-term follow-up, delineation of the POH etiology that is treated, RCTs with low risk of bias, and be absent conflicts of interest or industry sponsors. Trial registration: Prospero Systematic Review Registration ID: CRD42019135968

Hand eczema is a recurrent and resistant disease that seriously affects the quality of life of patients; currently, there are no ideal treatments for hand eczema. Here, we describe two patients who presented with hand eczema to illustrate the potential efficacy of mesotherapy with snake venom pharmacopuncture (SVP). A 23-year-old woman (Case 1) and a 47-year-old woman (Case 2) presented to the clinic with symptoms of pruritic rash, blis-ters, and itchiness on both the hands and the left hand, respectively. Both patients were diagnosed with hand eczema based on the physical examination of blisters and redness only on the hands. The patients underwent 1 month (Case 1) and 1 week (Case 2) of mesotherapy with SVP. After treatment, the lesions completely improved and did not recur at 1 year of follow-up. These outcomes suggest that mesotherapy with SVP may be effective for the resolution of hand eczema; however, further research is needed to confirm these findings.

The desire to maintain youth as long as it possible in modern society, especially among women of working age, is primarily due to the desire to be in demand, well-groomed and attractive. Currently, there are 5 main methods that contribute to improving the condition of the skin of the face, namely: the method using professional cosmetics, chemical peels, mesotherapy, treatment with an injection of botulinum toxin type A (BTA) and intradermal implants based on hyaluronic acid. The aim of the literature review was to analyze the latest scientific data on the possibility of botulinum therapy in cosmetology. Wrinkles of open areas of the body (primarily on the face and in the decollete) have a negative effect on the emotional background and quality of life of women. In this regard, recently there has been a significant increase in demand for aesthetic medicine services, one of the areas of which is botulinum therapy (BT). Botulinum toxin type A (BTA) is a powerful neurotoxin that inhibits the release of acetylcholine in the neuromuscular junction. Injections of small doses of botulinum toxin type A into targeted mimic muscles cause their relaxation, which smoothes the underlying layer of the skin, thereby regressing mimic wrinkles. Today, according to officially approved indications, it is used in cosmetology, botulinum therapy is used to correct mimic wrinkles in the upper third of the face, drooping corners of the mouth, in the complex correction of the face oval, in the treatment of axillary and palmar hyperhidrosis. Blocking a tear mediator like acetylcholine, not only the presynaptic membranes of neuromuscular synapses are rich, but also many anatomical structures, such as glandular tissue (sweat, other glands, etc.). This commonality of the mechanism of action on various physiological processes in our body allows us to make an assumption about the great potential of botulinum therapy in the treatment of a number of diseases associated with impaired neuromuscular conduction.

Cheilitis is the most common mucocutaneous side effect of isotretinoin (ISO). Dexpanthenol (DXP) increases fibroblast proliferation and re-epithelialization in wound healing. We aimed to investigate the effect of DXP-mesotherapy in ISO-induced cheilitis in this study.This study was conducted on patients who had been using ISO (0.5-1 mg/kg/day) for at least 2 months. Twenty-five patients who administered DXP-mesotherapy (mesotherapy group) and 33 patients without the procedure (control group, only ointment) participated in this study. All patients were prescribed only hamamelis virginiana distillate in ointment form as a lip balm. The efficacy of the treatment was interpreted by the change in lip balm use frequency, quality of life, and Isotretinoin Cheilitis Grading Scale (ICGS).There was a statistically significant decrease in all ICGS-subgroups scores in the mesotherapy group after 1 month compared with the baseline (p = 0.001), although in the controls, erythema, crust, and fissure scores significantly increased (p = 0.001, p = 0.002).While there was no difference between the groups in terms of ICGS total scores at baseline, there was a significant difference after 1 month in favor of the mesotherapy group (p 0.001). In the mesotherapy group, lip balms were needed significantly less frequently and there was a significant improvement in quality of life compared with both the control group and at baseline after 1 month (both; p 0.001). On the other hand, the control patients suffered more from cheilitis and dryness than at baseline (p 0.001).Dexpanthenol-mesotherapy seems to be a safe, and so effective method in management of ISO-related cheilitis.

This study was aimed at evaluating the efficacy of Tranexamic Acid (TA) mesotherapy versus cysteamine 5% cream in the treatment of melasma. This single-blind, randomized clinical trial was conducted among 54 subjects between 2018 and 2019. Cysteamine 5% cream group was instructed to apply the cream on the melasma lesions 30 min before bed for 4 consecutive months. Conversely, 0.05 mL (4 mg/mL) TA mesotherapy was performed by a physician every 4 weeks until 2 months. The severity of melasma was evaluated using both Dermacatch® device and the modified Melasma Area Severity Index (mMASI). The most remarkable improvement rate was observed in the TA group at the third visit based on mMASI and Dermacatch® values at 47% and 15% in turn. The mMASI scores were substantially improved in both groups at the second visit (cysteamine vs TA 8.48 ± 2.34 and 7.03 ± 3.19; P = 0.359) and third visit (cysteamine vs TA 6.32 ± 2.11 and 5.52 ± 2.55; P = 0.952) as compared to baseline (cysteamine vs TA: 11.68 ± 2.70 and 10.43 ± 2.69). Dermacatch® values were significantly declined at the second and third visits (cysteamine vs TA 42.54 ± 12.84 and 38.75 ± 9.80, P = 0.365; 40.74 ± 12.61 and 36.17 ± 10.3, P = 0.123, respectively) compared with baseline (cysteamine vs TA 45.76 ± 13.41 and 42.41 ± 10.48), although the improvement rates between two groups were not significantly different. Findings suggest that none of the cysteamine and TA mesotherapy treatments measured by both mMASI and Dermacatch® methods have substantial advantages over the other; however, complications are less in the cysteamine than the TA mesotherapy group.

Pain evaluation during local injections is a complex process. Injections cause patient's distress, especially when the target is a sensitive area such as scalp. Nonpharmacological methods as vibration before and during the procedure have been used to reduce pain. Mesotherapy has become a popular nonsurgical procedure for nonscarring alopecia, such as androgenetic alopecia (AGA) and alopecia areata (AA). Vibration has been successfully used in dermatological procedures, pediatrics, and dentistry. No study was found on vibration anesthesia during scalp mesotherapy. To analyze the effect of a vibration anesthetic device (VAD) during scalp mesotherapy on the patients' comfort.This is a randomized split-scalp study; thirty patients received mesotherapy with or without VAD on half of their scalp. Numerical rating scale (NRS) was used to measure self-reported pain. To test difference in means and medians in comparing device use and by treatment (AGA or AA), Student's t tests and Wilcoxon signed rank tests were used. Overall mean pain score on the no vibration-assisted side was 8.0 ± 1.0 while pain score for the vibration side was 2.3 ± 1.5, for AGA (P < .001) and 7.4 ± 1.2 and 2.1 ± 1.3, respectively, for AA (P < .001). Findings were similar for medians. No complications were found following procedure. To the best of our knowledge, this is the first study analyzing the effect of VAD in patients undergoing scalp mesotherapy. The VAD technique was found to be safe, effective, simple, and suitable for scalp procedures.

Objective: To observe the clinical effect of mesotherapy with nanochip for facial rejuvenation.Methods: 24 volunteers with aging skin were treated with a polycomponent formulation – NCTF® BOOST 135...

Atrophic scars, a permanent complication of severe acne, have negative effect on psychology in adolescent. The treatment of atrophic scar is depended on types of scar and it is difficult to improve by a single treatment. Mesenchymal stem cell is a scientific approval for surgery scar treatment and wound healing. We present a case report of female presented with atrophic acne scar distributed on both cheeks. The case aims to prove that the combination of MSCs and aqueous human placenta extract (RGF&#174) contained bioactive therapeutic molecules obviously promoted the improvement of skin scar to reach the optimal outcomes. We first found that MSCs-contained human placenta extract solution combination subcision improves the atrophic acne scar and skin complexity by enhancement of skin cell regeneration.

As a minimally invasive procedure, mesotherapy has been used in the cosmetic field for half a century and gets favorable results in fat reduction, facial rejuvenation, and hair regrowth. So far, it has achieved some exciting progression in pattern hair loss (PHL), which bothers plenty of people and has cost billion dollars searching for more effective treatment. The aim of this study is to summarize the efficacy of mesotherapy treating PHL.Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, and Web of Science were searched until January 2021. All literature was evaluated according to established criteria.We got 336 studies from searched databases, and 12 studies were included after selection process. A total of 253 males and 274 females participated in 6 randomized control trials, 2 nonrandomized controlled trials, and 3 observational studies. Mesotherapy showed positive efficacy in all studies to a certain extent, and no significant side effect occurred.Mesotherapy demonstrated as an effective treatment for PHL. However, the sample size is not big enough, and studies about mesotherapy compared to other treatments are insufficient. Future research is required to claim more evidence.

Scalp injection with mesotherapy (LC cell hair essence) helps in anchoring hair follicles and might have good therapeutic efficacy and lower side effects than Botox in the treatment of androgenetic alopecia (AGA).To assess the trichoscopy and the clinical therapeutic response of LC hair essence serum injection vs. botulinum toxin (A) injection in the treatment of androgenetic alopecia.Sixty-two AGA patients were included in the present study. Group I consisted of 31 patients who were injected with 1 ml of LC hair essence serum diluted with 0.5 ml of 0.9% normal saline once weekly for 8 weeks, and Group II involved 31 patients who were injected with 50 units of botulinum toxin A. Trichoscopic examination and photo documentation were done for every case before starting treatment (baseline) and after treatment with monthly follow-up to the patients.There was a significant difference between baseline trichoscopy findings and at the end of sixth month in Botox group, and the difference was highly significant in LC group; there was a statistically significant increase in the frequency of side effects (irritation and headache) among Group II compared with that of Group I.Botox can induce significant results in the treatment of AGA with mild and tolerable side effects but with high cost, while LC hair serum exhibit excellent results with fewer side effects.

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Introduction Vitiligo is one of the most common hypomelanoses. Current treatments include ultraviolet, topical corticosteroids, calcineurin inhibitors. Orally administered vitamins, acting as anti-oxidants and in combination with ultraviolet light have also demonstrated skin re-pigmentation. In our pilot study of seven patients, we injected skin affected with vitiligo intra-dermally with a complex of vitamins and minerals and assessed the outcome. Aim The aim of this study was to evaluate a novel treatment modality for vitiligo. Methods We present a pilot study of seven patients; each having been diagnosed with generalized progressive vitiligo. In all cases, multiple therapies had been previously attempted. All patients were subjected to intradermal injections of biorevitalizant NCTF 135 (3 mls) in the hypo-pigmented areas of skin, once a week for 5 weeks. A 30Gx13 mm needle was used for the 0.025 mls intradermal injections to create micro-papules with a 1 cm distance between the injection sites. The results were assessed at 2 weeks and 5 weeks and were considered successful if partial or complete repigmentation was achieved. Results Partial or complete skin re-pigmentation post-treatment was observed in vitiligo macules of all patients (100%). No significant side effects, or exacerbation of vitiligo were observed during or after treatment with NCTF 135 in the following 6 months (five patients) and 12 months (two patients). Discussion Increasing the armamentarium of new treatments of vitiligo is important. Previous studies showed the effectiveness of oral and intramuscularly injected multivitamins in the treatment of vitiligo, explaining the results by the antioxidative qualities of the above. Our study demonstrated that intradermal mesotherapy injections of NCTF135, rich with vitamins and other antioxidants are well tolerated and effective in achieving significant re-pigmentation of de-pigmented skin in all patients studied, including five who had been resistant to previous standard therapies.

Resumo Introdução: a alopécia ligada a fatores hormonais androgênicos é algo que há muito tempo tem sido alvo de estudos e aplicações de conhecimento científico em todo mundo. Este padrão de perda capilar, principalmente ligada ao sexo masculino dispõe de terapias que atualmente se limitam à interrupção da queda de fios com leve progressão de crescimento em alguns casos. Neste tocante, uma nova técnica de microagulhamento, com ou sem terapias adjuvantes, associado a métodos já consagradas como minoxidil tem levado o tratamento desta alteração estética para melhores níveis de resultado. Objetivo: conduzir uma investigação sobre os resultados atuais de pesquisas que envolvam o microagulhamento associado ao uso de Minoxidil, plasma rico em plaquetas e/ou mesoterapia. Metodologia: foram feitas pesquisas no banco de dados da PubMed e Scielo em abril de 2021 buscando-se os termos “minoxidil AND microneedling”. Resultados e Discussões: os resultados obtidos têm convergido para a proposta de que a associação do método de rolagem (microagulhamento) com a aplicação tópica do vasodilatador (minoxidil) apresenta um padrão de crescimento capilar nunca alcançado pela terapia convencional disponível, e que, se acrescentar plasma rico em plaquetas e/ou soluções através da mesoterapia, os resultados podem ser ainda mais vantajosos. Conclusão: novos estudos são necessários para abranger as vertentes ainda não elucidadas para o tratamento da alopecia, contudo, os resultados até aqui obtidos são promissores para o sucesso da reposição capilar. Palavras chave: Microagulhamento, Minoxidil, Alopecia Abstract Introduction: alopecia linked to androgenic hormonal factors is something that has long been the subject of studies and knowledge applications worldwide. This pattern of hair loss, mainly related to males, has therapies that are currently limited to interruption of hair loss with slight growth progression in some cases. In this regard, a new microneedling technique, with or without adjuvant therapies, associated with well-established methods such as minoxidil has led the treatment of this esthetic alteration to better levels of results. Objective: to conduct an investigation into the current results of research involving microneedling associated with the use of Minoxidil, platelet-rich plasma and/or mesotherapy. Methodology: searches were conducted in the PubMed and Scielo database in April 2021, searching for the terms “minoxidil AND microneedling”. Results and Discussions: the results obtained have converged to the proposal that the association of the rolling method (microneedling) with the topical application of a vasodilator (minoxidil) presents a pattern of hair growth never achieved by the available conventional therapy, and that, if added platelet-rich plasma and/or solutions through mesotherapy, the results can be even more advantageous. Conclusion: further studies are needed to cover aspects that have not yet been elucidated for the treatment of alopecia, however, the results obtained so far are promising for the success of hair replacement. Keywords: Microneedling, Minoxidil, Alopecia

Microneedling can accelerate skin repair through numerous complex processes triggered by micro-injuries it produces on the skin surface with very thin needles. The current growth in the application of microneedling in the treatment of cutaneous diseases can be explained by its numerous effects on the skin as reported in the literature. Despite the numerous studies conducted on the application of microneedling in the treatment of skin lesions, its effects on pigmented skin lesions have remained relatively unexplored. The present review comprises an examination of the evidence for the application of microneedling in skin diseases in general and a comprehensive review of the applications of microneedling in pigmentation disorders. The review involved a search of all clinical studies, including trials, case reports, and case series, in the databases MEDLINE/PubMed and Google Scholar using the following keywords: "microneedling", "dermal needling", "percutaneous collagen induction", "skin needling", "dermaroller", and "dermatology disorder". Pertinent data were extracted from all relevant articles published from 1990 to April 2021, and focused on the application of microneedling in the treatment of pigmented skin lesions. Despite the limited number of available studies, evidence suggests the effectiveness and safety of microneedling in treating vitiligo, melasma, and periorbitalhypermelanosis. It is noteworthy that the combination of any type of non-aggressive needing technique with other effective therapies (especially topical agents and mesotherapy) yields more promising therapeutic results than single therapy for melasma, dark cycles and vitiligo as the prototype of pigmentary disorders. However, single needling therapy is significantly effective, too. This article is protected by copyright. All rights reserved.

BACKGROUND Melasma is a common hyperpigmentation disorder. This study aimed to compare the efficacy of Nd-Yag fractional 1064 plus microinjection of tranexamic acid versus Nd-Yag fractional 1064 plus oral tranexamic acid in patients with melasma. MATERIALS AND METHODS This is a prospective, randomized study with a sample size of 40 patients, 20 in each treatment arm, which was done six times with 2-week intervals. Twenty patients were administered localized microinjections (4 mg/ml) of tranexamic acid and Q-switched 1064 laser every 2 weeks in one arm, while in the other arm, 20 were given oral tranexamic acid 250 mg three times a day and Q-switched 1064 laser every 2 weeks per visit. RESULTS Twenty-one patients with mean SD 40.52+-4.95 y/o were treated with oral tranexamic acid, and 20 patients with 43.3+-5.87 y/o treated with microinjection of tranexamic acid were analyzed. There was no statistically significant difference between the two groups in terms of demographic and clinical characteristics at the baseline (p > 0.05). The patients MASI score and ∆E decrease over the study period in both treatments significantly (p

Alopecia after mesotherapy with dutasteride is an extremely rare complication. Dutasteride is a second-generation 5a-reductase enzyme inhibitor that decreases serum dihydrotestosterone levels by 90%. It inhibits both type 1 and 2 enzymes, whereas finasteride inhibits only type 2. Mesotherapy with dutasteride is a novel treatment for hair fall which involves microinjection of the drug into the dermis with negligible systemic absorption. Frequent mild transitory side effects in the site of injection are described in medical literature, but few cases of secondary alopecia have been reported. This stands out given that mesotherapy is becoming such an increasingly common procedure with a great number of patients treated with this technique. We present 2 cases of patchy alopecia after mesotherapy with dutasteride in a male and a female with androgenetic alopecia. One of them developed skin atrophy on the affected areas without improvement at short term follow-up. These cases highlight the possible paradoxical side effects of mesotherapy as a therapeutic technique for hair loss.

Introduction: Mesostyle is a needle free mesotheraputic device that is able to insert analytical pure active substance to the deep layers of skin within cell levels using the most modern electroporation procedure. Objectives: this study aimed to assess electroporation "as a method of transdermal administration of medications" in treatment of corticosteroid induced striae in systemic lupus erythematosus patients. Methods: Twenty female Systemic lupus erythematous (SLE) patients suffering from corticosteroid induced striae in different body parts, were included in this study. Patients were subjected to full history taking, complete clinical examination, and assessment of disease activity using systemic lupus erythematosus disease activity index (SLEDAI) score. Each patient received treatment in the form of six weekly successive cessions using electroporation device "Mesostyle" and photos were obtained after each cession. Results: We found marked improvement of striae appearance with noticeable patients’ satisfaction without any adverse effects. Conclusion: This study supports the role of electroporation which is safe, tolerable, non-invasive, and effective method for transdermal administration of medications.