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Objective: 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. Materials and methods: 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. Results: 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). Conclusions: Vitamin C mesotherapy showed better and early effect than topical gel, and both techniques were not painful and esthetically satisfying in managing gingival hyperpigmentation. Clinical relevance: 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. [ABSTRACT FROM AUTHOR]

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 periorbital hypermelanosis. 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. [ABSTRACT FROM AUTHOR]

There are two main processes that induce skin aging: extrinsic and intrinsic. Extrinsic aging is caused by environmental factors such as sun exposure, air pollution, smoking, and poor nutrition. Intrinsic aging reflects the genetic background especially in terms of cell viability and proliferation potential, and depends on time. It introduces unfavorable changes in the functioning of organs and in the external appearance of the body, especially visible on the skin. Wrinkles, discoloration and loss of facial contours can reduce the quality of everyday life and disrupt human social relationships. There are now a couple of theories of aging to explain this inevitable fact of being human like: genetic, Hayflick’s, mitochondrial, biochemical and protein impairments theories. Both surgical and non-surgical aesthetic procedures are used to maintain a beneficial appearance, rejuvenation and slow down skin aging. From year to year, public interest in the use of innovative anti-aging treatments increases, enabling the preservation of youthful appearance for a longer period than it results from the physiological life cycle. Non-surgical aesthetic treatments, delaying skin aging, activate natural mechanisms of cell renewal and accelerate their metabolism, stimulate the synthesis of fibroblasts to produce collagen, which is the main building element of the skin. The most effective treatments delaying skin aging currently include, among others lifting with polydioxane threads, skin regeneration with platelet rich plasma, microneedle and needle mesotherapy, plasmage lifting as well as dermabrasion and microdermabrasion treatments combined with chemical exfoliation. Professional and systematic stimulations of cells allow lengthening and restoring the beneficial appearance of the skin in all its layers. Treatments using polydioxane threads restore the distorted face oval and lift the skin around the eyes. The procedure using platelet-rich plasma activates cell growth factors, improving the regenerative processes of mature skin. A non-surgical face lift called plasmage, allows excess tissue to evaporate in order to reduce and eliminate wrinkles and drooping eyelids. Various types of mesotherapy and dermabrasion treatments affect the reconstruction of the skin structure, reduce fine wrinkles and stimulate fibroblasts to produce new collagen and elastic fibers.

Veronika A Konstantinova,1 Olga Yu Olisova,2 Victor V Gladko,3 Ekaterina P Burova2–4 1Dermatology and Cosmetology Department Dao Clinic, Leninskiy Prospekt, Moscow 119119, Russia; 2Rakhmanov Department of Dermatology and Venereal Diseases, I.M.Sechenov First Moscow State Medical University of the Russian Federation, Moscow 119435, Russia; 3Department of Dermatology, Venereology and Cosmetology Medical Institute of Continuing Medical Education, Moscow State University of Food Production, Moscow 125080, Russia; 4Dermatology Department Bedford Hospital NHS Trust, South Wing, Bedford MK42 9DJ, UKCorrespondence: Ekaterina P BurovaDermatology Department Bedford Hospital NHS Trust, South Wing, 27 Rothsay Road, Bedford MK40 3PT, UKTel +447771857936Email katya.burova@gmail.comIntroduction: 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.Keywords: antioxidants, vitamins and minerals, mesotherapy

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.

Objective: Injectable skin fillers offer a wider range of options for cutaneous anti-aging and facial rejuvenation. PLLA microspheres are increasingly favored as degradable and long-lasting fillers. The present study focused solely on the effect of PLLA on dermal collagen, without investigating its impact on the epidermis. In this study, we investigated the effects of PLLA microspheres on epidermal stem cells (EpiSCs)., Methods: Different concentrations of PLLA microspheres on epidermal stem cells (EpiSCs) in vitro through culture, and identification of primary rat EpiSCs. CCK-8 detection, apoptosis staining, flow cytometry, Transwell assay, wound healing assay, q-PCR analysis, and immunofluorescence staining were used to detect the effects of PLLA on EpiSCs. Furthermore, we observed the effect on the epidermis by injecting PLLA into the dermis of the rat skin in vivo ., Results: PLLA microspheres promote cell proliferation and migration while delaying cell senescence and maintaining its stemness. In vitro, Intradermal injection of PLLA microspheres in the rat back skin resulted in delayed aging, as evidenced by histological and immunohistochemical staining of the skin at 2, 4, and 12 weeks of follow-up., Conclusion: This study showed the positive effects of PLLA on rat epidermis and EpiSCs, while providing novel insights into the anti-aging mechanism of PLLA., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Dong, Zhang, Yu, Zhou, Zhang, Wang, Hu and Luo.)

Numerous scientific papers have compared different treatment options in the management of myofascial pain syndrome. This study evaluated the efficacy of Extracorporeal ShockWave Treatment (ESWT) and mesotherapy in patients with Myofascial Pain Syndrome (MPS) in terms of improvement in pain, functional capacity, and quality of life. A case-control study was conducted on 54 patients, who were randomized into 2 groups: group A, consisting of 27 patients, who were treated with 5 sessions of focal ESWT on a weekly basis; and group B, consisting of 27 patients, who underwent 5 sessions of mesotherapy with Thiocolchicoside fl 4 mg/2 mL and Mepivacaine fl 10 mg/1 mL on a weekly basis. Patients were evaluated at enrollment (T0), after 5 weeks, at the end of rehabilitation treatment (T1), and at a follow- up 30 days after the end of treatment (T2), by administering rating scales (Numeric Rating Scale (NRS) - Pressure Pain Threshold (PPT) - Short Form-36 (SF-36)). The results showed that focal ESWT and Mesoterapy are two valid and effective treatment options in reducing algic symptoms and improving short- and long-term quality of life. However, the use of ESWTs, despite being mildly painful but tolerated, has been shown to be superior to mesotherapy in terms of pain reduction and increased functional capacity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Scaturro, Migliorino, Lauricella, Quartararo, Calabrese, Tomasello, Vecchio and Letizia Mauroˡ.)

Patterned hair loss (PHL) is a severe hair condition that affects both sexes. Mesotherapy is a treatment that involves microinjecting medications and/or vitamins into the middle layer of the skin. Mesotherapy reduces systemic adverse effects by delivering drugs directly to the hair follicle, increasing local bioavailability while lowering systemic exposure. Local side effects and reactions may develop due to mesotherapy. This study systematically evaluated the safety and efficacy of mesotherapy to minoxidil 5%, as well as addressing its limitations, dosing, and technique, with the intent of providing valuable trials and insights for clinicians and patients considering mesotherapy for improved androgenetic alopecia (AGA) outcomes. The literature search carried out by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria yielded 11 relevant studies from an initial pool of 18 articles. These studies covered various aspects of the role of mesotherapy and minoxidil in AGA, including techniques, complications, limitations, and outcomes. In conclusion, available trials and research on mesotherapy and minoxidil demonstrated excellent statistical significance and a high patient satisfaction rate, with the exception of two publications that took into account certain uncommon adverse effects of mesotherapy. However, recent research suggests that a mesotherapy method for alopecia with a low risk of side effects is effective., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Aledani et al.)

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 various indications on the face and body, such as wrinkle treatment, skin tightening, contour improvement, skin texture improvement, scars and acne scars, inflammatory acne, and mesotherapy. The treatments are comfortable and have no long downtime. By using high-quality needles with a small diameter, there is usually no bleeding or scabbing. The platform also offers optional additional device equipment for further treatment options. The purchase price is 26,900 euros and the monthly installment starts at 459 euros. Further information is available at MBC Medical Bio Care GmbH. [Extracted from the article]

Background: The objective of this study was to evaluate the effectiveness and safety of tranexamic acid mesotherapy in the treatment of melasma in the Moroccan population. Materials and Methods: All the patients received an intradermal injection of tranexamic acid (5 mg/mL). No other local or general treatment was administered. The patients were kept under external photoprotection only. Pre- and post-treatment photographs were taken and analyzed with the Visioface® RD hardware. The evaluation was employed the MASI score. Results: All patients had a dark skin phototype. The average duration of melasma evolution was 3.67 years. The pre-treatment average MASI was 7.6. The post-therapeutic average MASI was 6. The Visioface® RD hardware estimated a 25% reduction in the surface area attained at month five. No serious side effects were reported. Conclusion: Tranexamic acid was proven to be an essential tool in treating melasma. [ABSTRACT FROM AUTHOR]

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 are a safe and effective treatment option for ETR. The optimal number of monthly sessions has yet to be determined. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Intradermotherapy is considered a minimally invasive procedure, which works through applications of diluted pharmacological drugs, resulting in facial rejuvenation. Methods: 18 women were divided equally into two groups and evaluated before and after treatment (at 45 and 90 days). Four applications were made to the facial region at 15-day intervals; for group 1, traditional injections were given to introduce the anti-ageing substance, and, for group 2, a placebo intervention (0.9% saline application) was given. Results: In the analysis of the group 1 photos, greater filling of the nasogenian groove was observed after two sessions, and the presence of less deep wrinkles in the perioral area was also observed after four treatment sessions. Subjects in both groups complained of pain during the application, even with the use of anaesthetic. Most of the volunteers in group 1 said that the texture of the skin seemed much firmer and classified the therapy as an 'excellent treatment'. Conclusion: Intradermotherapy shows favourable results in the treatment of facial rejuvenation in women, which is more evident 90 days after the initial application. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Injection lipolysis or mesotherapy gained popularity for local fat dissolve as an alternative to surgical liposuction. Phosphatidylcholine (PPC) and aminophylline (AMPL) are commonly used compounds for mesotherapy, but their efficacy and safety as lipolytic agents have been controversial. Glycerophosphocholine (GPC) is a choline precursor structurally similar to PPC, and thus introduced in aesthetics as an alternative for PPC. This study aimed to evaluate the effects of GPC on adipocytes differentiation and lipolysis and compared those effects with PPC and AMPL using in vitro and in vivo models. Adipogenesis in 3T3-L1 was measured by Oil Red O staining. Lipolysis was assessed by measuring the amount of glycerol released in the culture media. To evaluate the lipolytic activity of GPC on a physiological condition, GPC was subcutaneously injected to one side of inguinal fat pads for 3 days. Lipolytic activity of GPC was assessed by hematoxylin and eosin staining in adipose tissue. GPC significantly suppressed adipocyte differentiation of 3T3-L1 in a concentration-dependent manner (22.3% inhibition at 4 mM of GPC compared to control). Moreover, when lipolysis was assessed by glycerol release in 3T3-L1 adipocytes, 6 mM of GPC stimulated glycerol release by two-fold over control. Subcutaneous injection of GPC into the inguinal fat pad of mice significantly reduced the mass of fat pad and the size of adipocytes of injected site, and these effects of GPC were more prominent over PPC and AMPL. Taken together, these results suggest that GPC is the potential therapeutic agent as a local fat reducer. [ABSTRACT FROM AUTHOR]

Objectives: Androgenetic alopecia (AGA) is characterized by progressive patterned hair loss from the scalp affecting both men and women. The aim of this study was to evaluate the influence of intradermal administration of meso-solution (MS) along with topical application of 5% minoxidil lotion on hair re-growth. Materials and Methods: Sixty healthy adult men (32.6 ± 4.3 years of age) with a history of hair loss completed the 12-month study. They were equally randomized into two groups. Subjects enrolled in Group A (n1 = 30) received once-daily topical application of 5% minoxidil lotion, whereas those in Group B (n2 = 30) received additional intradermal injection of MS (Stem C'rum HL, Caregen Co. Ltd, Anyang-si, Gyeonggi-do, South Korea) using a mesogun every 15 days for 3 months and then once every month for 9 months. Hair re-growth was evaluated using a 7-point rating scale. Results: Data collected were subjected to chi-square test. Results indicate that there is a statistically significant (P < 0.05) increase in hair re-growth in individuals in Group B at 6 months. This progressed to a highly significant (P < 0.001) increase at 9 and 12 months. Conclusion: Intradermal administration of MS using a mesogun along with minoxidil yielded a statistically significant increase in hair re-growth as compared to only minoxidil application. [ABSTRACT FROM AUTHOR]

BACKGROUND: The search for alternatives in the application of platelet rich plasma (PRP) that allow achieving the same or better results with less or no adverse event has motivated the use of virtual mesotherapy (electroporation). OBJECTIVE: To assess whether virtual mesotherapy (electroporation) is equal to or more effective and safer than real mesotherapy in the treatment of facial cutaneous photoaging with platelet-rich plasma. MATERIALS AND METHODS: A prospective, randomized, open and controlled pilot study was carried out in 40 patients with facial skin photoaging at the Hospital Hermanos Ameijeiras from March 1st, 2019 to March 30th, 2020. PRP was applied with two different mesotherapeutic interventions, group 1 (control group, intradermal PRP administered with needles) and group 2 (PRP administered with electroporator), and they were compared with each other. RESULTS: There were included 40 patients; 20 in each group. Light and moderate partial response was obtained in 19/20 patients in group 1 and in 17/20 patients in group 2 (p = 0.605). The adverse events found were pain (20/20), inflammation (20/20) and bruising (6/20) in group 1 and none in group 2 (p < 0.001). The degree of satisfaction was good in 12/20 in group 1 and in 20/20 in group 2 (p < 0.05). CONCLUSIONS: PRP application by electroporation was as effective as conventional mesotherapy, without any adverse event and with a higher degree of satisfaction. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. [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. [ABSTRACT FROM AUTHOR]

The research progress made by domestic and foreign experts on the methods and technologies of hair growth has been summarized, including the hair-growth effects of natural plant extracts, mesodermal therapy and stem cell therapy. The development trend in the field of hair growth has been prospected. Mesotherapy has the advantages such as convenient operation, good targeting, fewer side effects and being cost effective. The combination of mesotherapy with anti-hair-loss cosmetic products containing natural plant extracts may have very broad application prospects. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of 70% Glycolic acid peeling with Tranexamic acid mesotherapy in treating melasma. Study Design: Quasi-experimental study Place and Duration of Study: Department of Dermatology, CMH-Abbottabad Pakistan, Jun to Nov 2021. Methodology: The 54 patients aged 20-50 years were enrolled and randomly assigned into two groups. In Group-A, 27 patients prescribed 70% Glycolic acid every two weeks for 12 weeks (6 sessions) and in Group-B, 27 patients injected every week for 12 weeks (12 sessions) with Intradermal Tranexamic acid (4mg/ml). All patients had a clinical examination using the mMASI scale. On follow-up, evaluation was carried out on the 1st, sixth, and 12th weeks. Results: The majority of 35(65%) patients had mild MASI scores. The paired t-test results of Group A and Group B were both significant, while the post-treatment mean of Group A and B was insignificant. Conclusion: The study concludes that Glycolic acid and TXA are equally efficient in treating melasma. Moreover, Tranexamic acid reduced the recurrence of melasma, but topical application of Glycolic acid showed more compliance. [ABSTRACT FROM AUTHOR]

• Novel low-molecular-weight hyaluronic (HA) - drug conjugates were synthesized. • Tranexamic acid, Kojic acid, Cysteamine, and Cannabidiol were used as drugs. • These conjugates were explored to treat the UV-induced pigmentation in pig. • Mesotherapy with the these conjugates caused a decrease in pigmentation. • HA-drug conjugates can be used as efficient depigmenting medications. Drug combination therapy is commonly used to treat hyperpigmentation. However, treatment success is often limited due to the insufficient activity of combined drugs. To improve the therapeutic efficacy of drug combination treatment, we synthesized and investigated several conjugates comprising homo- and heterogeneous anti-pigmenting drugs bound to a hyaluronic acid (HA) carrier through distinct biodegradable linkers. These HA-drug conjugates demonstrated a measurable drug release profile in hydrolytic media. Most of the tested conjugates, administered by mesotherapy after UV-light-induced pigmentation in a swine model, presented superior depigmentation over corresponding controls. Among them, the dendron-like conjugate, NH 2 -TXA-Tris-TXA -(EtCMB) 3 , that contains only tranexamic acid (TXA), was most effective at depigmenting the swine skin compared to its equimolar mixture of HA and TXA (control). These results emphasize the importance of conjugation depigmenting agents to HA for augmenting the efficacy of treatment and motivate the use of HA as a delivery platform for treatment of various skin disorders. [Display omitted] [ABSTRACT FROM AUTHOR]

Abstract The incidence of nontuberculous mycobacterial infections is increasing worldwide; by 2017, more than 190 species and subspecies have been documented. Although classically associated with immunosuppression, the recognition of these etiological agents in diseases affecting immunocompetent individuals and in healthcare-associated infections, such as after surgical and cosmetic procedures, makes the study of the epidemiology and pathogenesis of these microorganisms relevant in medical practice. Mycobacterium lentiflavum is slow-growing and rarely affects the skin. A case of cutaneous mycobacteriosis caused by M. lentiflavum is reported in an immunocompetent patient after subcutaneous injection of a lipolytic compound, treated with clarithromycin and levofloxacin.

Abstract A 28-year-old white female patient presented with multiple erythematous-to-violaceous, painful, suppurative nodules on the buttocks and thighs that appeared after two weeks of mesotherapy with deoxycholate, caffeine, sunflower liposomes, and sinetrol for localized fat. She was treated for atypical mycobacteriosis, but with no satisfactory response after antibiotic therapy. Bacterial, mycobacterial, and fungal culture were all negative. Histopathologic examination of the biopsy showed noninfectious suppurative panniculitis. It resolved after treatment with methotrexate, prednisone, and hydroxychloroquine. This report highlights the rarity of this complication, the importance of its early recognition, and differentiation with atypical fast growing mycobacterioses.

T Paolucci,1 RG Bellomo,2 MA Centra,1 N Giannandrea,1 L Pezzi,1 R Saggini11University G.d’Annunzio Chieti, Department of Medical and Oral Sciences and Biotechnologies, Chieti-Pescara, Italy; 2University of Study of Urbino Carlo Bo, Department of Biomolecular Sciences, Urbino, ItalyBackground: Mesotherapy can be included as an ancillary treatment in the management of localized pain in rehabilitation, but there are no definitive treatment protocols for this approach.Objectives: The purpose of this review was to examine new indications for more standard protocols of mesotherapy in rehabilitation.Materials and methods: This systematic review was performed using the following resources: PubMed, Cochrane, PEDro, Scopus, and Google Scholar. The following algorithm was developed, based on the PICO acronym, to evaluate the effects of mesotherapy, with pain as the primary outcome (MESH terms): [mesotherapy AND pain], [mesotherapy AND musculoskeletal], [mesotherapy AND musculoskeletal disorder], [intradermal therapy AND pain], and [intradermal therapy AND musculoskeletal disorder].Results: Seven articles (N=7) satisfied the inclusion criteria and were considered in the review: two of them treated osteoarthritis of the knee (3 sessions) and pes anserine (9 sessions) emphasizing a good efficacy of mesotherapy. Five studies analyzed spine diseases (specifically, two was about chronic and nonspecific neck pain, two about acute low back pain and one about chronic spinal pain): the results of mesotherapy treatment are encouraging both for the resolution of acute and chronic musculoskeletal vertebral pain from one to five sessions.Conclusion: Mesotherapy showed a good effect to reduce acute and chronic musculoskeletal pain and, also, it is a well-tolerated treatment. Nonetheless future randomized controlled trials should be desirable for more uniform treatment protocols.Keywords: mesotherapy, intradermal injection, rehabilitation, pain, musculoskeletal

Objectives: To conduct a systematic review of randomized controlled trials about the safety (number and severity of adverse events) and efficacy (pain reduction and functional improvement) of mesotherapy in musculoskeletal disorders, and to compare them with other therapeutic options, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Methods: A search of PubMed, Cochrane Library and Scopus database resulted in an initial total of 16,253 records. A total of 931 articles were included in the study. A final total of 7 articles, published from 1 Jan 1999 until 30 Apr 2020 were selected. Two independent reviewers selected potentially relevant studies based on the inclusion criteria for full-text reading. They evaluated the methodological quality of each study and included only studies of high methodological quality, according to the Physiotherapy Evidence Database scale. Results: Seven studies were included in the meta-analysis, and visual analogue scale scores before and after mesotherapy were considered. A statistically significant reduction in visual analogue scale score in the mesotherapy group was reported in comparison with the control group in all except 1 of the trials. Mesotherapy was found to be a safe procedure with mild and temporary side-effects, such as nausea, fatigue, numbness, sweating, headache, ecchymosis, bleeding, pain and local reaction at the injection site. Conclusion: Mesotherapy proved to be more effective than systemic therapy in the treatment of local pain and functional limitations caused by a variety of musculoskeletal conditions. However, because of the heterogeneity of the analysed studies in terms of injected drugs, administration technique, associated treatments, frequency and total number of sessions, more randomized controlled trials are needed, comparing a standardized mesotherapy protocol with a systemic treatments.

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. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia (AGA) with its precursor miniaturization of anagen phase (MA) and telogen effluvium (TE) represent nonscarring hair loss diseases which causes moderate to severe aesthetic and psychologic discomfort in affected people. Several therapeutic approaches have been tested through the latest decades, with different degree of success. In this study we aim to analyze the efficacy and outcome of an innovative therapeutic protocol, named TRICHOBIOLIGHT, a combination of active principles conveyed by mesotherapy directly on the scalp with a subsequent photobiostimulation session with LED light (630 nm). About 107 patients (49 women, 58 men, mean age 45‐year‐old) with clinical and trichoscopic diagnosis of MA, AGA, and TE have been enrolled at Skin Center of L'Aquila, Avezzano and Pescara (Italy) and subsequently treated with the TRICHOBIOLIGHT protocol. 4 patients dropped out at the beginning of the study: 2 patients because of an histological diagnosis of scarring alopecia and lichen scleroatrophicus, and 2 patients dropped out because of adverse reaction to the treatment. Excellent to good outcome have been reached in the 82.5% of patients (85/103), 9 patients (8.7%) reached a sufficient result while 7 patients (6.8%) partially respond to the treatment. Two patients (2%) did not respond at all. TRICHOBIOLIGHT is a promising protocol, working through the combined action of the active principles and the photobiostimulation, that lead to a strengthening and thickening of the residual hair, giving an optical thickening effect that provides high quality aesthetic results and, consequently, appreciable psychological results. [ABSTRACT FROM AUTHOR]

Background: Melasma is a common, multifactorial, and recurring disease which is not easy to treat. Aims: The purpose of this study is to evaluate the efficacy of microneedling in combination with Q‐switched neodymium‐doped yttrium aluminum garnet laser (QsNd‐YAG laser) for treatment of melasma. Patients/Methods: Fifteen female patients with epidermal or mixed‐type melasma on the face were included in the study. Patients were first treated with QsNd‐YAG laser, and then with microneedling containing mesotherapy products of biomimetic peptides, at the same session. Modified Melasma Area Severity Index (mMASI) scores were calculated before the first session and again 2 weeks after the last session. The same treatment protocol was repeated every 2 weeks for five sessions within period of 3 months of therapy. The evaluation was performed according to the before and after photographs taken from three angles including 90‐degree front and 45 degrees from left and right with the VISIA device. Results: Of the 15 patients included in the study, the mean mMASI scores before and after treatment were 9.2 ± 5.7 (3.8‐23.1) and 3.6 ± 4.0 (0.6‐16.8), respectively. mMASI scores were significantly reduced after completion of the protocol. Six (40%) patients had "very good response," 4 (26.7%) patients had "good response," and 5 (33.3%) patients were "unresponsive." Six (40%) patients were followed up for 1 year, and only 1 patient had a recurrence (6.7%). Conclusions: In addition to the use of photoprotective measures, multimodality treatment including QsNd‐YAG laser and microneedling with mesotherapy products containing biomimetic peptides is effective to treat melasma and they work synergistically. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Androgenetic alopecia (AGA) is the most common form of non‐cicatricial alopecia in both genders. Currently approved drugs for the treatment of AGA include topical minoxidil in women and topical minoxidil and oral finasteride in men. Other routes of administration of approved drugs have been proposed to enhance therapeutic results for AGA, including intradermal injections, known as mesotherapy. Mesotherapy—or intradermotherapy—is a non‐surgical procedure, consisting of multiple intradermal injections of pharmacological substances diluted in small doses. Although minimally invasive, mesotherapy may be related to mild side effects like burning, erythema and headaches, as a few reports indicate. Among the most serious adverse events, subcutaneous necrosis, scalp abscesses, and angioedema have been described. This multicenter retrospective, descriptive study aims to report 14 cases of frontal edema resulting from mesotherapy for AGA treatment. In our patients, the edema mostly arose in the first two sessions and lasted between 1 and 4 days, with a favorable outcome after a local cold compress. In all our cases of edema, lidocaine was the anesthetic used. Minoxidil and dutasteride might also play a role as causative agents. To the best of our knowledge, this is the largest case series focused on frontal edema after mesotherapy for AGA and gives clinicians helpful information for when performing this technique. Dermatologists should already consider and be conscious of this possible mesotherapy side effect, as it can be remarkably disruptive to affected patients. [ABSTRACT FROM AUTHOR]

Female androgenetic alopecia is one cause of alopecia in women, although the ideal treatment for this condition remains far from defined. The objective of this study was to evaluate the efficacy and safety of intradermal injections with 0.5% minoxidil for the management of female androgenetic alopecia in a randomized, placebo‐controlled trial. A total of 54 women diagnosed with female androgenetic alopecia were divided into two groups: one group received intradermal injections of 0.5% minoxidil, and the other received 0.9% saline. Biopsy, trichogram, Trichoscan (Tricholog GmbH, Freiburg, Germany), and self‐assessment findings were used to evaluate the outcomes of treatment with minoxidil. In the treated group, there was a significant increase in the terminal‐to‐vellus hair ratio (P <.001) and in the percentage of anagen hairs (P =.048) and an improvement in hair loss and volume (P =.021 and P =.028, respectively). These results show that intradermal injections with minoxidil were more effective than placebo (P <.001) in the treatment of female androgenetic alopecia with a good safety profile. [ABSTRACT FROM AUTHOR]

Background: Lipomas are benign adipocytic tumours. Surgical excision is the gold standard for treating such lipomas, but it results in unaesthetic scarring. Methods: A total of 126 patients were randomised into two groups. The patients in Group A underwent mesotherapy (n = 66) and those in Group B underwent surgery (n = 60). The patients in Group A group received six sessions of mesotherapy treatment at 2-week intervals. Both groups were followed up for 12 weeks, during which they were assessed for complications arising from treatment, reduction of the size of the lipoma and cosmetic outcomes. Results: The overall mean age of the patients was 32.93 (± 10.1) years old and the mean volume of the lipomas was 2.29 (± 3.8) mL. A 55.86% (P = 0.0032) mean reduction in the volume of lipomas was noted in the patients who received mesotherapy, while one patient showed a gain of 16% by volume. The patients in Group A (cosmetic score ≥ 4: 63%) were happier with the treatment than those in Group B (cosmetic score ≥ 4: 21%). Conclusion: Our findings indicate that mesotherapy modestly reduces the volume of lipomas with very few and minor complications and excellent cosmetic outcomes. [ABSTRACT FROM AUTHOR]

Introduction. Mesotherapy, also known as local intradermal therapy, widely used all over the world, is a technique used to inject substances into the surface layer of the skin. There are no international guidelines for the correct use of this technique and in many countries, it is still applied empirically without valid patient consent. The Italian society of mesotherapy has planned a study to assess the rationale and clinical applications based on current evidence. Methods. An independent steering committee, based on the available scientific literature, has formulated a series of clinical questions. 21 experts responded by writing an evidence-based document. From this document 30 statements were obtained which were presented to 114 experts using the Delphi method. Results. 28 statements reached a broad agreement on definition, technique, pharmacological rationale, indications and some crucial ethical aspects. Conclusions. Although further studies are needed to establish the clinical role of this technique in each field of application, our statements recommend the correct application according to the needs of the individual patient in full respect of ethics. [ABSTRACT FROM AUTHOR]

Introduction Mesotherapy is a wide range of minimally invasive injections. In mesotherapy, a mixture of various tonics is injected into the skin. These include plant extracts, various medications, vitamins, enzymes, hormones, growth factors, and other factors that will help treat alopecia. Most commonly, a mixture of platelet-rich plasma (PRP) and vitamins is used. In mesotherapy treatment for hair regrowth in the temporal region, zygomaticotemporal nerve blocks, supratrochlear nerve blocks, and supraorbital nerve blocks are given. The zygomaticotemporal nerve, supraorbital nerve, and supratrochlear nerve are the branches of the trigeminal nerve. They provide sensation on the lateral side of the forehead, which is the temple region.  Methods A sample size of 100 people was taken for the study who were undergoing mesotherapy in the bilateral temporal region for alopecia. Each group had 50 subjects: group I was given supratrochlear, supraorbital, and zygomaticotemporal nerve blocks as local anesthesia techniques, and group II was given supratrochlear and supraorbital nerve blocks. PRP was injected using an insulin syringe. Pain was assessed using a visual analog scale (VAS). Results During the procedure, a mean VAS of 1 and 3 was observed in groups I and II, respectively, during the procedure (p-value 0.023). A mean VAS of 3 and 5 was observed in groups I and II, respectively, after three hours (p-value 0.000). This shows a significant difference in the pain experienced by the subjects between the groups.  Conclusion This study proves that the zygomaticotemporal nerve, used along with supratrochlear and supraorbital nerve blocks, is better at producing analgesia and reducing pain., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Nagaja et al.)

Objective: To describe the effect of different substance combinations administered through mesotherapy in dogs with hip osteoarthritis., Animals: 104 dogs., Methods: In this retrospective study, 4 groups (dogs treated with a combination of lidocaine, piroxicam, and thiocolchicoside [MG]; dogs treated with lidocaine, piroxicam, and Traumeel [TG]; dogs treated with lidocaine, piroxicam, and glucosamine [GG]; and dogs treated with the same combination as in MG combined with a photobiomodulation session [MPG]) were set. For all groups, the same treatment frequency was followed. Response to treatment was measured with the Canine Brief Pain Inventory (divided into pain interference score and pain severity score), Liverpool Osteoarthritis in Dogs (LOAD), and Canine Orthopedic Index (divided into function, gait, stiffness, and quality of life) before treatment and 15, 30, 60, 90, and 120 days after treatment. Cox proportional hazard regression analysis was used to investigate the influence of treatment, age, sex, body weight, breed, and Orthopedic Foundation for Animals score., Results: Dogs had a mean age of 7.6 ± 3.1 years and body weight of 28.6 ± 5.5 kg. Hip osteoarthritis was classified as mild (4), moderate (70), or severe (30). Greater improvements were observed in MG and MPG. Kaplan-Meier estimators showed MG and MPG had longer periods with clinically significant results. Treatment was the covariable that contributed more frequently to the outcomes observed., Clinical Relevance: The combination used in MG, particularly combined with photobiomodulation, produced longer-lasting clinically significant results.

Mesotherapy is a convenient, safe and relatively painless non‐surgical procedure. It has found its way into the aesthetic world and is employed for various indications such as lipolysis, skin rejuvenation, pigmentation and hair loss. The procedure involves delivery of mixture or cocktail of different compounds (plant extracts, nutrients, enzymes, homeopathic agents, pharmaceuticals, vitamins, amino acids and other bioactive substances) into the dermis or subcutaneous layer. A variety of techniques have been employed. The newer no‐needle and micro‐needle techniques are less invasive. Ingredients of the chosen mesococktail depend on the indication and play a major role in the outcome. Despite its popularity, mesotherapy has a scarcity of large scale studies on its efficacy and safety profile. Nevertheless, the choice of the mesoproduct and technique must be done with great detail to achieve the best desired effect. [ABSTRACT FROM AUTHOR]

Pierre-Antoine Deglesne,* Rodrigo Arroyo,* Javier Fidalgo López,* Lilian Sepúlveda,* Evgeniya Ranneva, Philippe Deprez Research and Development, Skin Tech Pharma Group, Castelló d’Empúries, Spain *These authors contributed equally to this work Introduction: Silanol (organic silicon) has been used for decades in the treatment of skin photoaging as it stabilizes and maintains skin structures through hydrogen bonding electrostatic interaction with extracellular matrix (ECM) proteins or glycosaminoglycans. Organic silicon-based products are often presented as silanol derivatives which are currently associated to other structural molecules such as orthohydroxybenzoate, carboxymethyl theophylline alginate, ascorbate, acetyltyrosine, sodium lactate or mannuronate. Consequently, organic silicon formulations may differ substantially between the medical devices available on the market, which may result in additional effect on the skin. Therefore, there is a real need for a better characterization of the products in terms of their action on human skin and in vitro skin model. Materials and methods: In this in vitro study, the effect of RRS® Silisorg was analyzed. RRS® Silisorg is a dermal implant (CE Class III medical device) containing monomethylsilanol mannuronate associated to an antioxidant resveratrol. Skin fibroblast viability and capacity to induce the production of key ECM genes were evaluated in the presence of different concentrations of RRS® Silisorg. The key ECM genes selected were collagen type I, elastin and hyaluronan synthase type 2 (HAS2), which is the cellular enzyme responsible for high-molecular weight hyaluronic acid (HA) production. Viability was evaluated through 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay and expression was quantified by quantitative polymerase chain reaction. Results: RRS® Silisorg increased fibroblast gene expression of HAS2 in the first 24 hours, 25 times in the presence of 1 mg/mL of solution, followed by a collagen type I gene expression (4.7 times) and elastin expression (2.5 times) increase after 48 hours. Conclusion: These results demonstrate that the silanol-based medical device RRS® Silisorg sustains HA, collagen and elastin production in human skin fibroblasts in vitro. Keywords: dermal implant, mesotherapy, hyaluronic acid, collagen, organic silicon, photoaging

Traditional, complementary, and alternative medicine practices are used in the prevention, diagnosis, and treatment of a wide variety of diseases in the world. Such practices in Turkey are regulated by the “Regulation of Traditional and Complementary Medicine Practice” issued by the Ministry of Health in the Official Gazette of the Republic of Turkey (Issue: 29158, 27th October 2014). The appendix of this regulation defines 15 practices that can be applied in units and practice centers. These applications include; 1. Acupuncture, 2. Apitherapy, 3. Phytotherapy, 4. Hypnosis, 5. Leech therapy (Hirudotherapy), 6. Homeopathy, 7. Chiropractic, 8. Cupping, 9. Maggot therapy, 10. Mesotherapy, 11. Prolotherapy, 12. Osteopathy, 13. Ozone therapy, 14. Reflexology, and 15. Music therapy. In this review, the indications of these 15 applications in the field of neurology are examined and current opinions of the evidence-based medical data are summarized.

There is an increasing interest in complementary and alternative veterinary medicine (CAVM). There is, however, an uncertainty of the efficacy of these methods. Therefore, the aim of this systematic literature review is to assess the evidence for clinical efficacy of 24 CAVM therapies used in cats, dogs, and horses. A bibliographic search, restricted to studies in cats, dogs, and horses, was performed on Web of Science Core Collection, CABI, and PubMed. Relevant articles were assessed for scientific quality, and information was extracted on study characteristics, species, type of treatment, indication, and treatment effects. Of 982 unique publications screened, 42 were eligible for inclusion, representing nine different CAVM therapies, which were aromatherapy, gold therapy, homeopathy, leeches (hirudotherapy), mesotherapy, mud, neural therapy, sound (music) therapy, and vibration therapy. For 15 predefined therapies, no study was identified. The risk of bias was assessed as high in 17 studies, moderate to high in 10, moderate in 10, low to moderate in four, and low in one study. In those studies where the risk of bias was low to moderate, there was considerable heterogeneity in reported treatment effects. Therefore, the scientific evidence is not strong enough to define the clinical efficacy of the 24 CAVM therapies.

Transdermal delivery can be accomplished through various mechanisms including formulation optimization, epidermal stratum corneum barrier disruption, or directly by removing the stratum corneum layer. Microneedling, electroporation, a combination of both and also the intradermal injection known as mesotherapy have proved efficacy in epidermal-barrier disruption. Here we analyzed the effects of these methods of epidermal-barrier disruption in the structure of the skin and the absorption of four compounds with different characteristics and properties (ketoprofen, biotin, caffein, and procaine). Swine skin (Pietrain x Durox) was used as a human analogue, both having similar structure and pharmacological release. They were biopsied at different intervals, up to 2 weeks after application. High-pressure liquid chromatography and brightfield microscopy were performed, conducting a biometric analysis and measuring histological structure and vascular status. The performed experiments led to different results in the function of the studied molecules: ketoprofen and biotin had the best concentrations with intradermal injections, while delivery methods for obtaining procaine and caffein maximum concentrations changed on the basis of the lapsed time. The studied techniques did not produce significant histological alterations after their application, except for an observed increase in Langerhans cells and melanocytes after applying electroporation, and an epidermal thinning after using microneedles, with variable results regarding dermal thickness. Although all the studied barrier disruptors can accomplish transdermal delivery, the best disruptor is dependent on the particular molecule.

Today, the number of people who desire a healthy and youthful appearance is increasing. Therefore, there is a growing need for medical approaches that result in better skin quality. Mesotherapy is a method based on the subcutaneous injection of wide range of agents which are thought to be useful in several indications. Skin wrinkles, pigment changes, dehydration, laxity and sagging are the features of aging skin. Mesotherapy is used for rejuvenation of the face and neck, while it is thought to reduce wrinkles, increase elasticity and improve pigmentation disorders. However, the level of evidence is low. [ABSTRACT FROM AUTHOR]

Objectives: To compare the efficacy of tranexamic acid mesotherapy versus 0.9% normal saline for melasma by split-face study. Methods: It was a non-randomized clinical trial performed at the Dermatology ward of JPMC from September 2018 to June 2019 after getting approval from the Ethical Committee. A total of sixty patients were recruited in the study, who had symmetrical melasma on their faces. Both halves of the face were treated by Injection Tranexamic Acid (TA) with a dose of 4mg/ml and Normal Saline (NS) two weekly for twelve weeks. Hemi Modified Melasma Area and Severity Scoring (H-mMASI) was calculated at the start and end of the study. Analyses were done by SPSS version 23. P < 0.05 was taken as significant. Results: Mean of H-mMASI score was compared on both sides at the end of study, which showed significant reduction in mean score from 3.19 ±2.57 to 1.52 ± 1.2 (P < 0.05) on A side as compared to decline in scores on NS side from 3.46 ± 2.7 to 3.45 ± 2.6 (P > 0.05). Erythema, swelling, and burning were documented as temporary side effects on both sides. Conclusion: Tranexamic Acid (TA) mesotherapy can be considered as the most cost-effective, safe and directly observed therapy for melasma which showed significant improvement when old prior therapies have failed. [ABSTRACT FROM AUTHOR]