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Objective: This study aims to investigate the level of evidence on the effectiveness and safety of 14 complementary and alternative medicine (CAM) methods that were legalized in Turkiye (Turkey). Methods: A systematic literature search was conducted in the Cochrane Systematic Review Database for acupuncture, apitherapy, hypnotherapy, leech therapy, homeopathy, cupping therapy, chiropractic, prolotherapy, osteopathy, maggot therapy, mesotherapy, music therapy, reflexology, ozone therapy. After screening, 178 studies were included in the qualitative synthesis. Evidence quality was classified as 'high/moderate/low'. AMSTAR-2 was used to evaluate the quality of systematic reviews. This study was registered to PROSPERO(CRD42019127509). Results: There are 16 low (LQE) and four moderate-quality evidence (MQE) of effectivity for various conditions were found for acupuncture, while it has no effectivity on 13 conditions. There are six LQE and one MQE on its safety. One study found high-quality evidence of the effectivity of apitherapy concluded honey accelerates healing of burn wounds. Thirteen LQE and three MQE showed the effectiveness of music therapy, while one study reported it as ineffective. Four studies found LQE showing hypnotherapy might be effective in some conditions, and one study found it was ineffective. Regarding osteopathy, one study found MQE, and one study found LQE. One study reported LQE for the effectiveness of chiropractic. The only evidence for the effectivity of homeopathy is of low quality and four studies have shown that it is not effective. Conclusions: Since there is insufficient evidence, 14 CAM methods legalised in Turkiye should not be used in routine medical practice. Future researches aiming to produce high-quality evidence are needed. [ABSTRACT FROM AUTHOR]

Combined methods of applying chemical peels and antioxidants could be an option for skin rejuvenation with no down-time. The penetration of active substances can be enhanced by microneedle mesotherapy. The study was conducted on a group of 20 female volunteers, aged 40–65 years. All volunteers received a series of eight treatments performed every seven days. The whole face was first treated with azelaic acid; following this, the right side received a 40% solution of vitamin C and the left side 10% vitamin C with microneedling. Hydration and skin elasticity were markedly improved, with better results observed on the microneedling side. Melanin and erythema index decreased. No significant side effects were seen. The combination of active ingredients and delivery techniques have great potential to enhance the effectiveness of cosmetic preparations, probably by multidirectional ways of action. In our study, we demonstrated that both 20% azelaic acid + 40% vitamin C treatment and 20% azelaic acid + 10% vitamin C + microneedle mesotherapy efficiently improved the assessed parameters of aging skin. However, the use of microneedling mesotherapy as a means of direct delivery of active compound to the dermis enhanced the effectiveness of the studied preparation. [ABSTRACT FROM AUTHOR]

Background and Objectives: Fibromyalgia is a very common musculoskeletal disease. The purpose of this study is to assess, on a population of fibromyalgic patients, the clinical efficacy of antalgic mesotherapy with diclofenac and thiocolchicoside in the treatment of cervical pain reduction for improvement of the functional capacity and quality of life of these patients. Materials and Methods: We conducted an observational study of 78 fibromyalgia patients recruited using our hospital database. Based on the different types of treatment received, the patients were divided into two groups: the treatment group (TG), who received antalgic mesotherapy with diclofenac, thiococolchicoside, and mepivacaina; and the placebo group (PG), who received mesotherapy with sodium chloride solution. Patients in both groups also received the same rehabilitation protocol of 20 sessions. The primary outcome evaluated was the extent of pain. The secondary outcomes were the functional capacity and quality of life. Results: Pain improved both in the treatment group (7.4 ± 1.2 vs. 5.1 ± 1.1; p < 0.05) and placebo group (7.5 ± 1.4 vs. 6.1 ± 1.6; p < 0.05). The treatment group, compared to the placebo group, also showed significant statistical improvements in functional capacity (NDI: 35.6 ± 5.23 vs. 19.3 ± 3.41; p < 0.05) and quality of life (SF-12: 18.3 ± 4.11 vs. 33.1 ± 2.41; p < 0.05). Conclusions: Mesotherapy treatment with diclofenac and thiocolchicoside is a safe and effective procedure in the management of neck pain in fibromyalgia patients in the short term in terms of pain reduction, functional recovery and quality of life. [ABSTRACT FROM AUTHOR]

Objective To investigate the types and causes of complications after facial injection with mesotherapy, and to summarize effective prevention and treatment methods. Methods From January 2015 to December 2021, there were 35 patients with bruising, redness, itching, folliculitis and other symptoms due to mesotherapy facial injection were retrospectively analyzed, and the pathogenesis and types of complications were analyzed, symptomatic treatment and systemic anti-inflammatory and anti-allergic treat-ment were taken to observe the treatment effect. Results A total of 35 patients in this group were followed up for 3 to 36 months, 29 cases recovered (82.86%), 4 cases were effective (11.43%), and 2 cases were ineffective (5.71%). Conclusion In view of the complications after facial injection of mesotherapy, symptomatic treatment should be taken in time, and the effect is accurate, which is worthy of clinical promotion and application. [ABSTRACT FROM AUTHOR]

Mesotherapy is a technique by which lower doses of therapeutic agents and bioactive substances are administered by intradermal injections to the skin. Through intradermal injections, mesotherapy can increase the residence time of therapeutic agents in the affected area, thus allowing for the use of lower doses and longer intervals between sessions which may in turn improve the treatment outcome and patient compliance. This systematic review aims to summarize the current literature that evaluates the efficacy of this technique for the treatment of hair loss and provides an overview of the results observed. Of the 416 records identified, 27 articles met the inclusion criteria. To date, mesotherapy using 6 classes of agents and their combinations have been studied; this includes dutasteride, minoxidil, growth factors or autologous suspension, botulinum toxin A, stem cells, and mesh solutions/multivitamins. While several studies report statistically significant improvements in hair growth after treatment, there is currently a lack of standardized regimens. The emergence of adverse effects after mesotherapy has been reported. Further large-scale and controlled clinical trials are warranted to evaluate the utility of mesotherapy for hair loss disorders. [ABSTRACT FROM AUTHOR]

NCTF®135HA is a bio-revitalizing solution containing hyaluronic acid designed to compensate for skin dehydration, fatigue, and fine wrinkles associated with endogenous and environmental aging. We conducted a randomized, active-controlled study to evaluate the efficacy and tolerability of NCTF®135HA injections on the face (crow's feet), neck, and décolleté regions. Subjects were randomly assigned (3:1) to receive three NCTF®135HA treatment sessions plus twice-daily anti-aging moisturizer cream or cream alone (control). The primary outcome was the reduction in superficial wrinkles between baseline and Day (D)75 in the three areas, assessed by profilometric measures, clinical scoring, subjective changes, and tolerability. 146 subjects were randomized to NCTF®135HA (n = 107) or control (n = 38). At D75 and D120, NCTF®135HA significantly reduced wrinkles in all three areas and improved facial radiance scores compared with the control. Skin hydration significantly increased 7 d after the last NCTF®135HA injection. Self-esteem scales showed statistically significant improvements at D75 and D120 in subjects treated with NCTF®135HA versus baseline. Most adverse events were mild, resolved within 48 h, and were related to the injection procedure. NCTF®135HA is an effective and well-tolerated treatment to reduce the skin signs of aging. The results are significantly superior to a routine anti-aging cream alone. (Funded by Laboratories FILLMED; ID-RCB number: 2018-A03167-48; clinicaltrials.gov number: NCT05609617) [ABSTRACT FROM AUTHOR]

Skin bio-revitalization improves skin quality globally; it permits the rejuvenation of the skin by increasing hydration and by reconstructing an optimal physiological environment for the skin cells together with a micro-filling effect. OBJECTIVE: To assess the comparative efficacy of a non-cross-linked hyaluronic acid (NCHA) preparation (M-HA®10, FILLMED Laboratories, France) on fine lines reduction and on skin hydration, radiance and mechanical properties, after three sessions of multiple intradermal injections, active versus placebo, on the face of subjects presenting aging signs. METHODS: Thirty healthy subjects received filler injections on one side and a control solution (saline) on the contralateral side of the face. Fine lines depth, skin hydration, and mechanical properties were evaluated using instrumental methods. Skin radiance, cheek fold and crow’s feet were scored clinically. In addition, Investigator and subject satisfaction rates were evaluated by the Global Aesthetic Improvement Scale and a subject self-assessment questionnaire. RESULTS: Ten days after the last multi-injection session, the following significant results were observed compared to the control: a reduction of both crow’s feet wrinkle depth (in the 110 to 1000µm range, -10% for NCHA and +7% for control) and clinical scoring of cheek wrinkles, and increases in skin radiance and hydration (+35%) and also skin firmness (+27%). The Investigator found that NCHA either improved or much improved the aesthetic aspect on 82% of subjects whereas no improvement was found on the saline side. Subjects found that NCHA significantly reduced wrinkles and increased both skin firmness and elasticity. CONCLUSION: Intradermal injection of NCHA can improve the quality of facial skin with aging signs by reducing fine wrinkles and improving hydration, firmness and radiance. [ABSTRACT FROM AUTHOR]

Introduction and purpose: Microneedle mesotherapy is a non-surgical method consisting in controlled micropuncture of the skin with very thin needles, associated with the insertion of active substances into it. It is used in many fields of medicine, diseases, as well as cosmetic defects associated with the symptoms of skin aging. The aim of this review is to summarize the side effects described in the literature that may associated microneedle mesotherapy. The review was based on the available data collected in the PubMed database searched using the keywords "mesotherapy", "adverse effects", "side effects". Description of the state of knowledge: Complications of mesotherapy can be divided into infectious and non-infectious as well as local and systemic. The most common and best known are bruises and swelling caused by local inflammation caused by certain substances. More serious complications include anaphylaxis, skin necrosis, granulomas, cellulitis, and infectious complications. Summary: Mesotherapy is a commonly performed procedure not only by doctors, but also by non-medical people. Both patients and operators tend to underestimate the potential side effects of this method. We hope that raising awareness and paying attention to the errors made will contribute to reducing the complications associated with this procedure, as well as to its standardization.

Mesotherapy has received public interest for rejuvenation; however, there is inconsistent and inadequate evidence of its efficacy. As aesthetic physicians, we believe the lack of efficacy for rejuvenation may be due to insufficient injection depth. The standards have not been updated for a long time, and thus doing so will provide patients with better results.

The GENTLO Microneedling RF platform of the latest generation, manufactured by HIRONIC from South Korea, has both the medical CE certification and FDA approval. It delivers excellent results for a variety of indications on the face and body, such as wrinkle treatment, skin tightening, contour improvement, skin texture improvement, scars, acne scars, inflammatory acne, pigmentation, promotion of hair growth, and mesotherapy. The treatments are comfortable and have no long downtime. By using high RF energy and long needle penetration with controlled heat release, a strong collagen neogenesis process is triggered and the texture of the skin surface is improved. The platform can be optionally equipped with other interesting handpiece technologies. The attractive purchase price leads to a quick return on investment. [Extracted from the article]

OBJECTIVE To describe the effect of a mesotherapy protocol in dogs with osteoarthritis. ANIMALS 30 dogs. PROCEDURES Dogs were randomly assigned to a control (CG; n = 10) or a mesotherapy group (MG; 20). CG received meloxicam for 70 days. MG was treated with a combination of lidocaine, piroxicam, and thiocolchicoside, injected in intradermal points. Seven treatment sessions were conducted. Response to treatment was measured with different instruments: the Canine Brief Pain Inventory (divided into Pain Interference Score [PIS] and Pain Severity Score [PSS]), Liverpool Osteoarthritis in Dogs (LOAD), and Canine Orthopedic Index (COI; divided into function, gait, stiffness, and quality of life), at time 0 (T0), +15 days, +30 days, +60 days, and +90 days after T0. At each time point, the results of the 2 groups with each instrument were analyzed with the Wilcoxon signed ranks test, P < .05. Kaplan-Meier estimators were compared with the Breslow test. RESULTS Dogs had a mean age of 6.9 ± 2.7 years and a body weight of 31.0 ± 6.4 kg. Hip osteoarthritis was classified as mild (n = 9), moderate (17), or severe (4). No differences were found at T0. Better results were observed in MG at +15 days (P < .01 for PSS and PIS, P = .03 for function), +30 days (P = .01 for PIS and LOAD, P = .03 for PSS, and P = .04 for function, gait, and COI), +60 days (P < .01 for PSS and PIS, P = .01 for LOAD, and P = .02 for function), and +90 days (P = .01 for PSS and PIS, P = .03 for LOAD, and P = .04 for function). Kaplan-Meier estimators showed MG had longer periods with better results than CG in various scores. CLINICAL RELEVANCE This mesotherapy protocol reduced pain scores and other clinical metrology instrument scores lasting for longer periods. [ABSTRACT FROM AUTHOR]

The aim of this pilot study was to investigate the effects of defocused and radial shock wave therapy, mesotherapy, and kinesio taping on pain, circumferences of lower limbs, echographic/elastosonographic pattern of subcutaneous adipose tissue (SAT), and quality of life in patients with lipedema. Fifteen women affected by lower limb lipedema in stage II were treated with shock wave therapy, mesotherapy, and kinesio taping on thighs and legs (eight sessions, twice a week). The primary outcome was pain, as assessed by Numeric Rating Scale (NRS). Secondary outcomes included the limb circumferences measurements, the SF-12 Health Survey for quality of life, the International Classification of Functioning (ICF) for disability, and echographic/elastosonographic changes of SAT. Significant reductions of pain and circumference measurements were seen in patients at each follow up. This was associated with significant reduction of thickness, echographic pattern improvement, and increased elasticity of SAT, with consequent positive impact on the quality of life and disability reported by the patients. The results demonstrate improved clinical and functional ultrasound findings in patients affected by lipedema in the early stages of lower limbs, and this combination therapy needs to be investigated in larger populations at multiple centers to confirm the findings. [ABSTRACT FROM AUTHOR]

Background: Mesotherapy is a method of treatment in which biocompatible substances are injected in small aliquots into different levels of skin. This technique can be used for facial rejuvenation. Aim: To comprehensively evaluate efficacy of different hyaluronic acid (HA) materials for skin rejuvenation, and discuss longevity of these products, potential adverse effects, and different injection techniques. Material and Methods: We searched Pubmed, Scopus, Web of science, Google Scholar, Embase, Cochrane Library, and Science direct until April of 2022. Thirty‐four articles were selected including 23 articles about non‐cross‐linked HA and 11 articles about cross‐linked HA. Results: Eleven and five different non‐cross‐linked HA and cross‐linked HA materials were utilized, respectively. Treatment sessions for non‐cross‐linked HA were between 1 and 6 at weekly‐to‐bimonthly interval, and for cross‐linked HA were 1–3 at 4–36 weeks apart. In most of the studies, serial micropuncture technique with 23–32 gauge needles was used for injection. Other injection techniques were Nappage (picotage), depot and micro‐linear. Conclusion: Mesotherapy with HA‐based fillers is a favorable method for restoring youthful appearance, rejuvenation, and revitalization of skin. Proper selection and precise placement of HA in desired level of dermis is an essential key to optimize improvement and minimize side effects including skin irregularities and Tyndall effect. Adjuvant therapy with additional rejuvenation procedures to enhance esthetic results is required especially in elderly individuals with severe photodamaged skin. Moreover, preservation of esthetic results requires maintenance therapy every few months. [ABSTRACT FROM AUTHOR]

Background: Members of Micobacterium. abscessus complex comprises three subspecies (M. abscessus subsp. Abscessus, M. abscessus subsp. Bolletii, and M. abscessus subsp. Massiliense) and are a rapid-growing nontuberculous mycobacteria present in different aquatic habitats and soil. It often causes a wide spectrum of infections involving pulmonary infections, surgical wound infections, and infections related to mesotherapy, catheters, hemodialysis devices, endocarditis, and disseminated infections in immunocompromised individuals. Methods: In this article we comment on the most relevant aspects of nine patients with skin lesions caused by M. abscessus subsp. massiliense infection. Clinical characteristics, histopathology, and molecular identification were performed. Results: The patients in the clinical cases presented a history of trauma, tattoos, and physical therapy techniques. The most common treatments were minocycline and clindamycin, doxycycline, ceftriaxone, cephalexin, moxifloxacin, rifampicin, and trimethoprim-sulfamethoxazole. The evolution of the treated patients was acceptable, except for one patient, who showed a partial improvement. M. massiliense were identified in all clinical cases using a species-specific PCR. Conclusion: Our series consisted of nine cases of skin biopsies recorded in different years; for this reason, we do not have all the data necessary for a complete description, in particular in four cases, causing limitations in the manuscript, especially in the therapy used and the evolution of patients due to lack of follow-up. [ABSTRACT FROM AUTHOR]

Background: The face is the area most exposed to the normal course of skin aging, both intrinsically and extrinsically. The aim of the study was to evaluate the cellular and clinical response of a therapeutic protocol aimed at countering facial skin aging. Materials and Methods: Twenty female patients with facial skin laxity and photodamage underwent combined therapy including mesotherapy using non-cross-linked hyaluronic acid with calcium hydroxyapatite and an infrared energy-based device treatment with subsequent implementation of PEG-cross-linked hyaluronic acid soft tissue fillers. To evaluate the benefits, patients underwent histological, immunological, and biomechanical evaluations before the treatment and at 21 and 150 days after the treatment. Results: The histological results at 21 days and 150 days after the procedure showed an increase in the number of fibroblasts and angiogenesis. As for the immunological aspect, it was shown that the treatment has an immunomodulating action, avoiding the activation of CD4 and CD8 cells. Biomechanical data showed that, at 150 days after treatment, the average changes in skin elasticity increased by 72% and the skin hydration increased by 49%. Conclusions: A combination of an infrared energy-based device treatment with both non-cross-linked hyaluronic acid and novel PEG-cross-linked hyaluronic acid leads to numerous positive cutaneous changes after histological, immunological, and biomechanical evaluations. [ABSTRACT FROM AUTHOR]

Background: Female Pattern Hair Loss (FPHL) is one of the most common types of hair loss in women. It is characterized by progressive follicular miniaturization leading to diffuse hair thinning over the midfrontal scalp with a negative impact on quality of life. Pharmacological treatments are commonly used, and hair follicle transplantation is an option for those cases with adequate donor area. Minimally invasive procedures, such as microneedling, mesotherapy, microinfusion of drugs into the scalp with tattoo machines (MMP®), and platelet‐rich plasma (PRP) have been reported as adjuvant treatments. Aims: This study aims to summarize and discuss the efficacy of minimally invasive procedures described for the management of FPHL. Methods: Published articles indexed on the Pubmed database and Scopus that described minimally invasive procedures for the management of FPHL in humans were considered. Citations were reviewed and added for completeness. The search was for articles in English only. After excluding duplicate titles, 23 relevant articles were considered. Conclusion: Minimally invasive procedures are promising options and may play a role in FPHL treatment. They can be used as adjunctive therapy for FPHL, in case of poor response to clinical therapy, or when patients prefer other care than the standard. We reinforce that these methods should be performed by an experienced medical professional following strict aseptic techniques. However, microneedling, mesotherapy, MMP, and PRP lack standardization and are supported by a low level of evidence yet. For the future, larger randomized clinical trials are essential to determine the efficacy and optimal protocols for these treatments. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The use of epidural steroid injection in spinal stenosis pain management has expanded greatly. Calcitonin is also effective in relieving neuropathic pain in spinal canal stenosis through the mechanisms of arterial dilation, anti-inflammation, anti-edema, and rises in beta endorphin levels. The current study was designed to evaluate the effect of mesotherapy with calcitonin compared with epidural steroid injection for pain relief and functional improvement in patients with lumbosacral canal stenosis. Methods: A total of 39 patients comparable in age and gender with signs and symptoms of lumbosacral canal stenosis participated in this randomized control trial. Group A comprised patients receiving mesotherapy of 100 IU Calcitonin+Marcaine 0.5% (4 mL) in three repeated injections in the lumbosacral area; group B received a single caudal epidural injection of Marcaine 0.5% (4 mL)+80 mg methyl prednisolone (2 mL) under the guide of a fluoroscope. Patients were evaluated before and 4 and 8 weeks after intervention using the visual analog scale (VAS), Oswestry Disability Index (ODI), Quebec back pain disability scale (QBPD), and Ronald-Morris Disability Questionnaire (RMDQ). Results: Based on the VAS, ODI, QBPD, and RMDQ scales, a significant improvement in pain and functional disability was observed in both groups 4 and 8 weeks after intervention (P0.05). Conclusion: Mesotherapy with calcitonin Marcaine is just as effective as caudal epidural steroid injection; considering its advantages, mesotherapy can be a proper alternative method for managing pain and functional impairment in patients with lumbosacral canal stenosis.

Background Melasma is a hypermelanotic disorder, which poses therapeutic challenge. Tranexamic acid (TA) and glutathione are novel therapies for the treatment of melasma. Aim To compare the therapeutic efficacy of localized intradermal microinjections (mesotherapy) of TA versus microinjections of glutathione for the treatment of melasma. Methods This prospective, comparative study was carried out to assess the therapeutic efficacy of TA and glutathione in 64 patients with dermal melasma after obtaining written informed consent, over a period of 12 weeks. Face of the patient was divided into two halves (split face); right cheek was injected with TA and the left with glutathione, at baseline (zero), 4th, 8th, and 12th weeks. The treatment response was assessed by using visual analog scale (VAS); photographs were taken to ascertain the improvement and its percentage was calculated. A parametric test, Student t test, and Z test were applied wherever applicable. P-value of

Introduction: Isotretinoin (ISO)-associated cheilitis is the most common side effect and the most common reason for discontinuation of ongoing therapy. So, various lip balms are also routinely recommended for all patients. Objectives: We aimed to investigate the effectiveness of local intradermal injections (mesotherapy) of dexpanthenol into the lips to prevent ISO-associated cheilitis. Methods: This pilot study was conducted on patients over the age of 18 using ISO (about 0.5 mg/kg/day). All patients were prescribed only hamamelis virginiana distillate in ointment form as a lip balm. In the mesotherapy group (n=28), 0.1 ml of dexpanthenol was injected into each lip tubercle (4 points total) to the submucosal level. The patients in the control group (n=26) used only the ointment. “ISO cheilitis grading scale (ICGS)” was used in the evaluation of ISO-associated cheilitis. The patients were followed for 2 months. Results: Although there was an increase in ICGS scores in the mesotherapy group compared to the baseline, no statistically significant change was observed after treatment (p=0.545). However, in the control group, there was a statistically significant increase in ICGS scores in the 1st and 2nd months compared to the baseline (p

The article discusses about the use of dutasteride mesotherapy as a therapeutic option for androgenetic alopecia, emphasizing its potential benefits and limitations due to a lack of extensive, placebo-controlled clinical trials and variations in methodology among studies. The article also mentions the need for further research to establish universal recommendations for this treatment method.

Telogen effluvium is one of the most common forms of diffuse, non‐scarring hair loss for which patients present for clinical evaluation. It is usually a reactive and reversible disorder. Identifying and correcting the underlying cause is the most important component in management, yet there is always a need for therapeutic options. This study aims to evaluate the efficacy of single session botulinum toxin A injection versus multiple sessions of multivitamins mesotherapy in the treatment of telogen effluvium. A randomized clinical trial was conducted in the Dermatology, Venereology, and Andrology Department, Faculty of Medicine, Zagazig University Hospitals. Twenty‐four patients with telogen effluvium were randomly divided into two groups each group included 12 patients. Group I received a single session of Botulinum toxin A injection and group II received multiple sessions of multivitamins mesotherapy injection. Both botulinum toxin A and multivitamins mesotherapy are effective in the treatment of telogen effluvium, which was reflected on the improvement of hair parameters as terminal hair and multiple follicular units. Both treatment modalities had minimal and well‐tolerated side effects. Although both therapies have equivalent success rates, single session of botulinum toxin A is a better choice than multiple mesotherapy sessions. [ABSTRACT FROM AUTHOR]

Introduction: 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. Methods: 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). Results: 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). Conclusion: Dexpanthenol‐mesotherapy seems to be a safe, and so effective method in management of ISO‐related cheilitis. [ABSTRACT FROM AUTHOR]

Background: Topical exogenous lipase has been approved for cosmetic use and has been used to mobilize fat from adipocytes. The objective of this study was to determine the effects of exogenous lipase in the subcutaneous adipose tissue. Methods: Three different concentrations of exogenous lipase 1× (2 Units per ml), 5× (10 units per ml), and 10× (20 units per ml) were applied in a porcine model. Normal saline (NS) solution (as negative control) and phosphatidylcholine (as positive control) were also injected. Skin and subcutaneous tissue biopsies, up to the fascia, were obtained from each injection site on the 3rd day after injection. The number of cells per 20× field was counted as an indirect measurement of the size of the adipocytes. Results: For 1× lipase, the number of cells per field was 47.80 (±7.63) versus 27.26 (±4.93), and 34.66 (±6.84) for NS, and phosphatidylcholine, respectively. For 5× lipase, the count was 36.06 (±4.74) versus 24.13 (±5.18), and 33.2 (±9.34). For 10× lipase, it was 40.06 (±4.35) versus 29.26 (±2.34) and 32.66 (±6.30) (p <.05 for all groups). Conclusions: A higher number of cells per field were observed in the lipase samples, inferring a decreased volume of adipocytes. No inflammation and/or loss of cell architecture were evidenced in the exogenous lipase groups. [ABSTRACT FROM AUTHOR]

Background and Objective: 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. Methods: 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. Results: 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. Conclusion: 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. [ABSTRACT FROM AUTHOR]

BACKGROUND: 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. OBJECTIVE: 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. METHODS: 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. RESULTS: Ten articles met the criteria set forth in the authors' literature review. Many of the procedures resulted in partial or complete resolution of alopecia. CONCLUSION: 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. [ABSTRACT FROM AUTHOR]

Introduction: Androgenetic alopecia (AGA) is the most common type of hair loss. Platelet-rich plasma (PRP) and mesotherapy (MZT) injections of various solutions fortified with growth factors are popular treatment options for AGA. The aim of this study was to compare the efficacy of RPP and MZT products in the treatment of AGA., Methods: This retrospective study included 72 AGA patients treated with two PRP formulations and two MZT products, administered manually or with a gun injector. Hair parameters (hair thickness, hair density, and hair count) on frontal and vertex areas were measured before and after 6 months., Results: Over 6 months, trichoscopic parameters showed significant intragroup and intergroup variability. MZT1 and PRP2 groups exhibited statistically significant improvement in most parameters, while MZT2 significantly increased vertex hair density. Hair thickness changes differed significantly between PRP1 and PRP2 groups (unadjusted p value <0.001) and possibly between MZT1 and PRP1 groups (unadjusted p value = 0.049) in both regions., Discussion: Injections of PRP and MZT formulations can significantly enhance trichoscopic parameters in AGA patients within a 6-month period, but the extent of improvement varies among different PRP and MZT products., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

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„Kissing Spines” or „impinging/overriding dorsal spinous processes” in the area of the thoracolumbar spine are amongst the back pathologies most commonly diagnosed in the equine athlete. The condition is defined as the narrowing of the interspinous space to less than 4 mm. Clinical signs are non-specific and do not necessarily correlate with the severity of radiographic findings. Regional analgesia is recommended for the diagnosis of clinically significant overriding spinous processes, as narrowing of the interspinous may be detected radiographically in horses with and without signs of thoracolumbar pain. A variety of medical and surgical treatment options are available for the management of clinically relevant overriding spinous processes in the horse. Medical management may involve systemic or local administration of anti-inflammatory drugs, muscle relaxants and bisphosphonates. Additionally, specific techniques like mesotherapy, shockwave therapy, neuromuscular electrical stimulation, capacitive resistive electric transfer, infrared therapy, kinesio-taping and acupuncture are described. Further manual therapies including physiotherapy and massage, chiropractic and osteopathy as well as specific aspects of training and exercise are discussed in this literature review. Part 1 of the literature review aims to detail the literature available concerning the conservative treatment options for the management of horses with overriding spinous processes. The review of the current literature highlights the importance of a combined therapy that includes local treatment as well as a consistent exercise protocol in order to achieve optimal rehabilitation in horses with thoracolumbar pain associated with overriding spinous processes. [ABSTRACT FROM AUTHOR]

Résumé: La mésothérapie est une technique médicale qui consiste à injecter à plusieurs reprises de faibles doses de médicaments dans les couches superficielles de la peau. Elle vise notamment les pathologies musculosquelettiques, dont la prise en charge passe par certains médicaments potentiellement porteurs d'effets indésirables. Par sa voie intradermique, elle pourrait présenter plusieurs avantages, mais également des inconvénients comme le risque infectieux. Les protocoles hétérogènes et le faible niveau de preuves des articles publiés questionnent sur son efficacité. Mesotherapy is a medical technique that involves repeatedly injecting low doses of drugs into the surface layers of the skin. It is targeted in particular for musculoskeletal diseases, the management of which requires certain drugs that may have adverse effects. By its intradermal route, it could present several advantages, but also disadvantages such as the risk of infection. The heterogeneous protocols and the low level of proof of the published articles question its effectiveness. [ABSTRACT FROM AUTHOR]

Massimo Mammucari,1 Teresa Paolucci,2 Domenico Russo,3 Enrica Maggiori,1 Raffaele Di Marzo,4 Alberto Migliore,5 Umberto Massafra,5 Gianpaolo Ronconi,6 Paola Emilia Ferrara,6 Fabio Gori,7 Barbara Bifarini,7 Stefano Brauneis,8 Renato Vellucci,9 Rocco Domenico Mediati,9 Bartolomeo Violo,10 Silvia Natoli,11 Carmen Pediliggieri,12 Cristiana Di Campli,12 Maria Chiara Collina12 1Primary Care Unit, ASL RM 1, Rome, Italy; 2Unit of Physical Medicine and Rehabilitation, G. D’ Annunzio University of Chieti-Pescara, Department of Oral Medical Science and Biotechnology (DSMOB), Chieti, Italy; 3“San Marco” Hospice and Palliative Care, Latina, Italy; 4Member of the Italian Society of Mesotherapy, Rome, Italy; 5Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, Rome, Italy; 6Physical Medicine and Rehabilitation Unit, IRCCS, Catholic University of Sacred Heart, Rome, Italy; 7Section of Anaesthesia, Intensive Care, and Pain Medicine, University Hospital Santa Maria Della Misericordia, Perugia, Italy; 8Pain Centre “Enzo BorzomatI”, University Hospital of Rome “Policlinico Umberto I”, Rome, Italy; 9Anaesthesiology Department, University Hospital Careggi, Florence, Italy; 10Pain Therapy Unit, S. Spirito Nuovo Regina Margherita Hospital, Rome, Italy; 11Department of Clinical Science and Translational Medicine, Tor Vergata University, Rome, Italy; 12Department of Vascular Surgery, Limb Salvage and Diabetic Foot, IDI-IRCCS, Rome, ItalyCorrespondence: Massimo MammucariPrimary Care Unit, Local Health, ASL RM 1, Rome, 00165, ItalyTel +39-06-61560695 Email massimo.mammucari@libero.itAbstract: Mesotherapy (local intradermal therapy, LIT) is a technique used to slowly spread drugs in tissues underlying the site of injection to prolong the pharmacological effect with respect to intramuscular injection. Recommendations for proper medical use of this technique have been made for pain medicine and rehabilitation, chronic venous disease, sport medicine, musculoskeletal disorders, several dermatological conditions, skin ageing, and immune-prophylaxis. Although mesotherapy is considered a valid technique, unresolved questions remain, which should be answered to standardize methodology and dosing regimen as well as to define the right indications in clinical practice. New randomized controlled trials are needed to test single products (dose, frequency of administration, efficacy and safety). Even infiltration of substances for dermo-cosmetic purposes must be guided by safety and efficacy tests before being proposed by mesotherapy. In this article, we put forth a preclinical and clinical research plan and a health technology assessment as a call to action by doctors, researchers and scientific societies to aid national health authorities in considering mesotherapy for prevention, treatment and rehabilitation paths.Keywords: mesotherapy, intradermal therapy, research plan

Rapid progression of aesthetic medicine is a distinctive feature of present decade. In this area, leading position is taken by injection cosmetology, which is associated with an opportunity of pathogenetic approach to resolution of cosmetic problems primarily caused by skin aging. The most commonly used mesotherapy drugs, along with hyaluronic acid, are vitamins, amino acids, and microelements. Skin aging is associated with quantitative and functional changes in the local immune cell populations. In this case, it is rational to assume distinct effects of peptide complexes upon functional potential of immunocompetent cells. The aim of this study was to analyze time-dependent changes of some immune parameters after mesotherapy with a complex of hyaluronic acid and peptides. The observation group consisted of 26 women who received their course of mesotherapy for the first time. Objective instrumental evaluation of the effect with Aramo Smart Lite device showed that, after mesotherapy, the skin quality was significantly improving in comparison with pre-treatment conditions, due to decreased relief of skin creases and wrinkles, with a tendency for reduction of this effect six months later. When comparing the results of immunological testing in the patients after the course of treatment with the data before starting the therapy, we have found redistribution in the lymphoid cell populations, i.e., increased proportion of T-lymphocytes, decreased amounts of B cells, and CD16+ natural killers. Declined numbers of T-lymphocytes expressing early activation marker were associated with increased proportion of peripheral Treg lymphocytes. We have also detected activation of antibody production which manifested as increased levels of all major classes of serum immunoglobulins. Enhanced spontaneous oxidative activity of neutrophils was also noted. The results of immunological monitoring showed that, three months post-treatment, none of the quantitative and functional parameters of immunity was changed, as compared with the results obtained immediately after ending the mesotherapy. Six months later, however, all these indexes returned to their initial positions assessed before the cosmetic procedure. The changes in systemic immune response following mesotherapy with peptide complexes affect the mechanisms of both innate and acquired immunity, including differentiation of lymphocytes, their regulatory functions and activation potential, and provide modulation of effector reactions. Complete restoration of initial immune parameters is observed within six months.

Objective. The study aimed to assess the dynamics of the systemic immune response in patients during mesotherapy with hyaluronic acid (HA).Materials and methods. The observation group included 26 women who received the first-time mesocorrection with drugs based on hyaluronic acid (HA). Injections of low molecular weight HA were carried out according to standard methods in a course of 5 procedures with an interval of 14 days. The parameters of the innate and adaptive immune response were studied before and two weeks after the end of the course. The skin condition was assessed by dermatoscopy (Aramo Smart Lite 300, Southern Korea).Results. The clinical effect of the course of procedures was reflected in the subjective improvement in the appearance. The improvement was confirmed by hardware analysis, which recorded an increase in hydration, a smoothing of the skin relief, and a decrease in the depth of wrinkles. At the end of the course, redistribution of lymphocyte populations towards natural killer cells and B-lymphocytes was revealed with a decrease in the total number of T cells. The antibody production of immunoglobulins of classes M and G was increased, the serum content of Ig A and IgE was reduced, the number of both T-effectors and T-lymphocytes with immunosuppressive activity increased. Changes in the neutrophil system were characterized by the inhibition of the production of reactive oxygen intermediates; the dynamics of the expression of Toll-like receptors by monocytes was ambiguous.Conclusion. The results of the study confirmed the active involvement of the factors of innate and adaptive systemic response in the cosmetic effect, which manifested itself immediately after mesotherapy as systemic dysregulatory immune changes.

Background and Objectives: Fibromyalgia is a very common musculoskeletal disease. The purpose of this study is to assess, on a population of fibromyalgic patients, the clinical efficacy of antalgic mesotherapy with diclofenac and thiocolchicoside in the treatment of cervical pain reduction for improvement of the functional capacity and quality of life of these patients. Materials and Methods: We conducted an observational study of 78 fibromyalgia patients recruited using our hospital database. Based on the different types of treatment received, the patients were divided into two groups: the treatment group (TG), who received antalgic mesotherapy with diclofenac, thiococolchicoside, and mepivacaina; and the placebo group (PG), who received mesotherapy with sodium chloride solution. Patients in both groups also received the same rehabilitation protocol of 20 sessions. The primary outcome evaluated was the extent of pain. The secondary outcomes were the functional capacity and quality of life. Results: Pain improved both in the treatment group (7.4 ± 1.2 vs. 5.1 ± 1.1; p < 0.05) and placebo group (7.5 ± 1.4 vs. 6.1 ± 1.6; p < 0.05). The treatment group, compared to the placebo group, also showed significant statistical improvements in functional capacity (NDI: 35.6 ± 5.23 vs. 19.3 ± 3.41; p < 0.05) and quality of life (SF-12: 18.3 ± 4.11 vs. 33.1 ± 2.41; p < 0.05). Conclusions: Mesotherapy treatment with diclofenac and thiocolchicoside is a safe and effective procedure in the management of neck pain in fibromyalgia patients in the short term in terms of pain reduction, functional recovery and quality of life.

Background: Cosmetic injection‐induced nodules are tricky to handle in the clinic. Aims: We reported a case of injection‐induced nodule receiving the experimental treatment of hyperbaric oxygen therapy (HOT). Patient: A woman presented with multiple red solid nodules on the neck after receiving mesotherapy conducted by syringe. Ultrasound examination showed multiple thickened inflammatory skin tissues on the neck. Pathological biopsy results showed epithelioid granulomas in the dermis, within which there were degenerative necrosis and foreign bodies in the center and multinucleated giant cells around. The bacteria tests remained negative. Diagnosed with foreign body granuloma, the patient rejected the resection or steroids, but willingly took the experimental treatment of HOT instead. After one month, the patient's ultrasound examination showed that the lesion's local hardness got significantly reduced, and the local blood flow increased, indicating the condition improved. Results: Although the patient's nodule has not been eliminated, some improvements have been achieved. So far there has no case report on HOT treating injection‐induced nodules in the literature. Conclusion: HOT may be considered as a potential alternative when other treatment options cannot be implemented. More research is needed in this field. [ABSTRACT FROM AUTHOR]

Context: Gonadotropins can be administered every 5 days under intradermal injection in in vitro fertilization (IVF) treatment. Objective: To explore the effectiveness of intradermal injection of recombinant human FSH (rhFSH) for women undergoing IVF. Methods: Women who received their first IVF treatment enrolled in this prospective intervention in 2018. All women received a bolus of 900 IU rhFSH intradermally at day 2 of the treatment cycle followed by additional dosage of rhFSH at day 7 and/or day 10. The main outcome measures included the total dose of rhFSH and number of injections required, sequential serum FSH level detected, and number of mature oocytes retrieved. Results: Seventy women completed the study. On average, 2.31 ± 0.73 injections and 1662 ± 397 IU of rhFSH were administered. While the baseline FSH level was 5.6 ± 2.2 IU/L, the serum concentrations of FSH after rhFSH administration were 35.3 ± 7.0 on the first day (24 hours) and 10.7 ± 3.7 IU/L on the fifth day (120 hours). A total of 10.5 ± 6.6 mature oocytes were retrieved, resulting in 7.3 ± 5.1 pronuclear embryos; 1.8 ± 0.6 embryos were transferred to the uterus. Our findings resulted in 72% fertilization, 91% cleavage, 31% implantation, and 36% live birth rates. Although fewer larger follicles were found, noninferiority results were noted in the mature oocytes retrieved, good embryos available, and clinical pregnancy rate compared with those received conventional daily subcutaneous rhFSH administration. Conclusion: Intradermal administration of rhFSH, with a smaller dose of rhFSH and fewer injections, may achieve the goal of a cost-effective and more patient-friendly regimen. [ABSTRACT FROM AUTHOR]

Background: Mesotherapy is a minimally invasive procedure which involves local intradermal therapy (LIT) with biologically active substances given in minor quantities to the area of pathology. Vitamin C is an important antioxidant agent which can modulate the attenuation of inflammatory process and enhance tissue repair. Aim: The aim of this study was to investigate the efficacy of local injections of Vitamin C for treating persisting inflammation of the gingiva. Materials and Methods: After phase I therapy was completed, five patients with persisting chronic inflammation of the gingiva were injected with the same dosages of Vitamin C into the gingival tissues. Patients were evaluated each week for resolution of gingival inflammation. Results: Clinical observation showed a significant improvement in inflammation of the injected sites during recall appointments. Conclusions: LIT with Vitamin C has a synergistic interaction along with scaling and root planing in the treatment of persistent gingival inflammation.

Since introduced in 1961, intralesional (IL) agent has become an essential part of the dermatological practice. The term IL referred to the direct delivery of agent percutaneously into skin lesions. This therapeutic approach is relatively safe, easy to perform and applicable for a broad range of dermatological conditions. On the other hand, immediate side effects, including pain during administration, bleeding, high risk of infection and allergic reaction, and subsequent side effects involving skin changes such as atrophy, telangiectasia, pigmentary changes, and striae are usually associated with this modality. This review paper highlights the pros and cons of IL agents in modern dermatology practice.

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.

Abstract Background Achilles tendinopathy (AT) is considered the commonest tendon pathology, occurring mainly in athletes. Different conservative treatment options have been introduced but with short-term effects; however, extracorporeal shockwave therapy (ESWT) and mesotherapy (MT) injections were claimed to provide longer effects and could be used in cases failure of response to conservative treatments. The objective of our prospective 12-week study was to compare the effect of ESWT and MT on chronic Achilles tendinopathy in athletes by both clinical and ultrasonographical assessment. Results Forty patients with chronic AT diagnosed clinically and with high-resolution ultrasound (US) randomly allocated in two groups first received weekly ESWT session, and the other group underwent weekly MT sessions for 4 consecutive weeks. Both groups improved during the treatment and follow-up period. The mean visual analogue score (VAS) decreased in both the ESWT group and the MT group. Mean American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score and VAS scores were not significantly different between ESWT and MT groups at the 4th and the 12th week of follow-up. However, US assessment significantly improved after 12 weeks in the ESWT group (as regards tendon thickness, calcifications, and Doppler signal), and for the mesotherapy group, there was the only improvement of tendon thickness. Conclusion ESWT showed improvement of pain and inflammation and calcifications of AT than MT injections, which was documented by US improved findings at week 12 follow up.

Background: Mesotherapy is a popular novel therapeutic modality that is defined as intradermal or subcutaneous microinjection of pharmaceutical compounds. Although this novel treatment method is used commonly in aesthetic dermatology, there is little information about details of injections, efficacy, and side effects of mesotherapy in melasma. Aim: In this review, we evaluated efficacy and safety of various types of mesotherapy in the treatment of melasma. Method: We searched Google Scholar, Medline, and PubMed for related articles with keywords "melasma" OR "chloasma" AND "mesotherapy" OR "injection." Inclusion criteria were articles that evaluated intradermal injection of lightening drugs and published dates between January 2000 and September 2021. Exclusion criteria were articles in languages other than English or non‐human studies. Results: Thirty‐three articles evaluated efficacy of mesotherapy in melasma, including 28 articles about tranexamic acid, 4 articles about vitamin C, 2 articles about glutathione, and 2 articles about triamcinolone. Conclusion: Mesotherapy is a good alternative or adjunctive choice in patients who are refractory to first‐line therapy, patients with low compliance with everyday use of topical therapy, patients with contraindication to oral tranexamic acid therapy, or who wish short downtime and fast recovery period. Further studies with large sample sizes are required to determine ideal concentrations of mesotherapy substances and intervals between sessions and to evaluate the efficacy of different substances for mesotherapy as monotherapy compared to combination therapy and other treatment modalities for melasma. [ABSTRACT FROM AUTHOR]

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 < 0.001). However, patient's MASI score (p = 0.99) and ∆E (p = 0.53) did not differ significant between the two group over the time. Satisfaction (p = 0.41) and complication during the study period (p = 0.09) were not significantly different between the two group. Conclusion: The combination treatment method can be a viable option for Middle Eastern patients having melasma disorder, and tranexamic acid appears to be an effective and safe treatment for melasma, irrespective of its route of administration. Tranexamic acid can increase the permeability locally by non‐invasive methods such as microneedling which is less painful than microinjection and can also increase patient satisfaction. Although the oral method is more tolerable for the patient, it may have systemic side effects, and its combination with Q‐switch laser increases its effect regardless of the type of prescription. Therefore, it is recommended to use of this drug topically (cream or lotion) by non‐invasive methods like microneedling to reduce pain and laser treatment in future studies. [ABSTRACT FROM AUTHOR]

Background: Melasma is a hypermelanotic disorder, which poses therapeutic challenge. Tranexamic acid (TA) and glutathione are novel therapies for the treatment of melasma. Aim: To compare the therapeutic efficacy of localized intradermal microinjections (mesotherapy) of TA versus microinjections of glutathione for the treatment of melasma. Methods: This prospective, comparative study was carried out to assess the therapeutic efficacy of TA and glutathione in 64 patients with dermal melasma after obtaining written informed consent, over a period of 12 weeks. Face of the patient was divided into two halves (split face); right cheek was injected with TA and the left with glutathione, at baseline (zero), 4th, 8th, and 12th weeks. The treatment response was assessed by using visual analog scale (VAS); photographs were taken to ascertain the improvement and its percentage was calculated. A parametric test, Student t test, and Z test were applied wherever applicable. P-value of <0.05 was considered statistically significant. Results: Out of 64 enrolled, 50 patients completed the study and it was found that the reduction in VAS score from baseline to 8th week and baseline to 12th week was significant in both the groups (P < 0.05). However, the mean difference in improvement percentage between baseline and 8th week and baseline and 12th week with TA was found to be more significant than glutathione. Conclusion: This study revealed that both TA and glutathione intradermal microinjections are effective in the treatment of melasma but TA is more effective. [ABSTRACT FROM AUTHOR]

Background. Intradermal therapy (mesotherapy) is a technique used to inject drugs into the surface layer of the skin. The intradermal micro deposit allows to modulate the kinetics of drugs, slowing down its absorption and prolonging the local mechanism of action. This technique is applied in the treatment of some forms of localized pain when a systemic drug-saving effect is useful, when it is necessary to synergize with other pharmacological or non-pharmacological therapies, when other therapies have failed or cannot be used. Aim. The purpose of our study was to evaluate the effect of a mixture with respect to its lower concentration. We also wanted to evaluate the number of sessions needed to reach the therapeutic goal (50% reduction in pain from baseline) in patients with acute or chronic neck pain. Method. We analyzed retrospectively data from 62 patients with cervicobrachial pain treated with intradermal drugs. Group A received a mixture of drugs; group B received half the dose of drugs. Results. Patients who received a lower concentration of drugs achieved similar results to those who received a higher dose. The therapeutic goal was achieved on average with 3.5 + 1.7 sessions on a weekly basis (min 1; max 9). Subjects in group A required 4±1.7 treatments (min 1; max 9), while subjects in group B required 3±1.5 treatments (min 1; max 7). Conclusions. Our study confirms that even a lower dose of drugs can induce a clinically useful result. This study confirms that the useful effect of mesotherapy is only partly due to the pharmacological action. Further randomized prospective studies are needed to standardize the technique in the various pain syndromes, but it is recommended to follow the guidelines of the Italian Society of Mesotherapy to ensure patients receive appropriate treatment. [ABSTRACT FROM AUTHOR]