Mesotherapy in dermatology 19 may 2010

MESOTHERAPY IN DERMATOLOGY

Dr. Amr Ismail MD

Consultant DermatologistMember of American Academy of Aesthetic Medicine

19th May 2010

email:ahmismai@gmail.com

Facebook: Laser and Skin Care Center

Definition

Mesotherapy employs multiple microinjections of pharmaceutical medications , amino acids , vitamins and others into the mesoderm.

Introduction

Mesotherapy was 1st described by a French Physician Michael Pistor 1952.

In 1987, French Academy of Medicine recognized Mesotherapy as part of traditional medicine.

Skin Structure

Embryonic origin Adult Derivative

Ectoderm Skin EpidermisBrainBreastSweat glands

Mesoderm Fibrous tissue (connective)CartilageBoneMuscleFat

Endoderm GutLiverLungPancreas

Skin Structure

Dermis

Connective Tissue = Cells + ECMatrix

Connective tissue is often used to describe the extracellular matrix plus the cells found in it, such as fibroblasts, macrophages, and mast cells.

ECM Structure

3 major fiber-forming proteins:

Collagen, elastin, and fibronectinGAG : Hyaluronic acid one of 7.Proteoglycans.

Mesotherapy

Connective Tissue Shock Therapy

How To Start

1. Materials

2. Injection sites

3. Injection Depths

4. Needle size

5. Machine

Mesotherapy in Depth

Non-prescription treatment. Non Conventional Safe Aesthetic

Procedure. Should rely on Evidence Based

Medicine.To achieve good results. Depend on Used Meostherapy

Materials.

Mesotherapy MaterialsClassification

A. Principals :

Ingredients that have been used orally or topically or injectable for treatment of each indication/condition.

Mesotherapy MaterialsClassification

A. Principals :

Ingredients with high grade of evidence in treatment of each indication/condition.

Ingredients that have been FDA Approved for treatment of each indication/condition.

Mesotherapy MaterialsClassification

B. Complementary :

Ingredients that have been claimed to improve the condition.

Ideal Mixtures

Mixtures should contain

2-3 principals to achieve satisfactory

results(>90%).

Mesotherapy

Indications:Hair : Hair Loss & AGA.Facial Rejuvenation. Facial Pigmentation.Body Sculpting.

I. Hair

Telogen Effluvium

Hair Growth Stimulants

Principals Complementary

Biotin

(Vitamin H/B7)

Pantothenic acid

(Vitamin B5)

Pyridoxine

(Vitamin B6)

Zinc + Azelaic acid

MV + MTE

I. Hair

AGA

Hair Growth Stimulants5-ARI

Principals Complementary

Minoxidil

Finasteride

Dutasteride

Zinc + Azelaic acid

Androgenetic Alopecia (AGA)

Minoxidil

Mechanism of action is unknown.Appears to lengthen the duration of the

anagen ( growth ) phase of hair.It may increase the blood supply to the

follicle. AGA: Hair regrowth is more pronounced

on the crown as well as the frontal scalp which is noted on at least 12 sessions.

5 alpha Reductase Inhibitors

DutasterideActs on the two isomers of the enzyme 5

alpha reductase thus it is effective in both males and females.

Acts against one isomer only iso-enzyme II thus it is ineffective in females

Finasteride

Does not give any burning sensations during the injection

Very painful and give burning sensation

The potency of dutasteride is greater than that of Finasteride Lower potency than Dutasteride

MesoHair Protocols

Telogen Effluvium Androgenetic Alopecia

Biotin (P)

Dexenol(P)

MV + MTE (C)

Minoxidil(P) /

Dutasteride(P) +

Biotin(P)

Dexenol(P)

Zinc + Azelaic (C)

MesoHair Injection sites & depths

II. Face MesoLift / MesoGlow

Rejuvenation (Principals)Hyaluronic acidAmino acidsVitamin CDMAEOrganic SiliciumFibronectin + Vegetal proteins (Collagen &

Elastin)

II. Face MesoLift / MesoGlow

Rejuvenation (Complementary)Vitamin AGlycolic acidTaurineXADNMV & MTE

Rejuvenating Principals

Hyaluronic acid: maintain hydration + elasticity of skin

Amino acids : 1. improve skin tone+ firmness + elasticity. 2. essential to compensate the reduced

fibroblasts activity. Vitamin C :

The only antioxidant that is proven to stimulate the synthesis of collagen

Rejuvenating Principals

DMAE :

1. Potent firming acts quickly and lasts long.

2. Acts in the neuromuscular union, as a precursor of acetylcholine, the neurotransmitter responsible for muscular contraction, increasing the overall tone of the skin.

Rejuvenating Principals

Organic Silicium/Silorg :

maintain ECM Hydration + Tone and Elasticity of skin

Fibronectin +Vegetal proteins (Elastin

and Collagen):

restore ECM components (fibronectin , collagen and elastin).

Complementary

Retinol/Vitamin A:

restore collagen and elastin.Glycolic:

stimulating new growth of collagen.Taurine : Antioxidant

helps collagenogenesis-----increases hydroxyproline dermal concentration.

Complementary

MV + MTE :

Activate the biochemical reactions. XADN:

composed of Procaine, Thiamine (Vitamin B1), Riboflavin (B2), Niacin (B3)Pantothenic Acid (B5), Pyridoxine (B6). Improve speed of metabolic reactions.

MesoGlow Protocols

Hyalift HA

Silorg

Purascorbol / Vitamin C

Xadenal

Hyalift

Silorgamine = Silorg + DMAE

Puretinol / Vitamin A

Taurinox

MesoGlow Protocols

Fibronectin

Elastine

Collagen

Silorg

DMAE

Vitamin C

HA

Silorg

MesoGlow Injection sites & depths

III. Face Pigmentation

MesoLighten / Depigmenting Principals Glutathione.Kojic acid.Azelaic acid.Vitamin C.Tretinoin.

MesoLighten Protocols

Kojic acid

Azelaic acid

Tretinoin

Vitamin C

with/without

Hyaluronic / silorg

Glutathione

Vitamin C

Kojic acid

Glycolic acid

MesoLighten Injection sites & depths

MesoLighten Injection sites

MesoLighten Injection sites

MesoLighten

IV. Body Sculpting

Localized Fat.Cellulite.Stretch marks.

A. Localized Fat

LipoDissolveInjection Lipolysis

Localized Fat ICCM / IAAL

Injection Lipolysis Mesotherapy

Deep 12mm

PPC + DOC (PCDC)

Hyaluronidase-Collagenase-

Artichoke

Intermediate 6mm

(L-Carnitine-Aminophylline-

Yohimbine- Artichoke)

2 - 4 mm

L-Carnitine

Aminophylline

Pentoxifylline

Effective complement

Phosphatidyl Choline (PPC)

An antioxidant derived from soy lecithin.PPC penetrates the adipocyte , breaks

down fat . Dissolved fat is carried through bloodstream and excreted by kidneys and bowel.

LipoDissolve + proper diet + Exercise.

Localized Fat/ Injection Lipolysis

Lipolytic Enhancers: Deoxycholate: Bile salt L-Carnitine: Enhances both lipolysis and fatty

acid oxidation . Artichoke: Direct lipolytic Hyaluronidase & Collagenase: PPC enhancer

Enzymes. Aminophylline , Caffeine & Xanthine.

Localized Fat/ Injection Lipolysis

Circulatory Enhancers:Yohimbine:Alpha2-adrenergic Blocker.Aminophylline &Pentoxiphylline: PDEI

Drainage Enhancers:Artichoke:Diuretic and stimulates

lymphatic drainage

Localized Fat/ Injection Lipolysis Protocols

PhosphatidylcholineDeoxycholic Acid Vitamin complexAlpha Lipoic AcidAmino Acids

PhosphatidylcholineDeoxycholic Acid Taurine Organic silicium

PhosphatidylcholineDeoxycholic Acid L-CarnintineAminophyllinePantothenic Acid

Localized Fat/ Injection Lipolysis Protocols

PhosphatidylcholineL-CarnitineProcaine

PhosphatidylcholineCaffeineYohimbine Procaine

LipoDissolve Injection sites & depths

LipoDissolve Injection sites

LipoDissolve Injection sites

B. Cellulite

Aesthetically cellulite is a problem consisting of the visual presentation of weakened and damaged fatty tissue and connective fibrous tissue in the form of bumps and dimples, commonly known as “orange skin”.

Cellulite

Cellulite

Cellulite

Treatment must act in two different ways:on the fat (Lipolytic effect) on circulation (Venotonic effect + Drainage)

Cellulite

Lipolytic:

L- Carnitine + Caffeine .Venostatic:

Rutin – Aminophylline –Pentoxiphylline.Drainage:

Artichoke.

Cellulite Protocols

L- Carnitine Aminophylline Pentoxiphylline Yohimbine DMAE Procaine

L- Carnitine Aminophylline Pentoxiphylline DMAE Vitamin C Procaine

MesoCellulite Injection sites

MesoCellulite

C. Stretch Marks

The connective tissue, including collagen and elastin, becomes increasingly damaged until eventually causing the formation of stretch marks.

Stretch Marks

Collagen Elastin Stimulating/ Restoring agentsOrganic Silicium / SilorgCentella AsiaticaVegetal proteins + Fibronectin

Firming agents DMAE + Vitamin CDMAE + Idebenone.

MesoStretch Marks Protocols

Silorgamine =

Silorg + DMAE

Centella Asiatica Fibronectin Vegetal Proteins

Idebe =

Idebenone + DMAE

Vitamin C DMAE Silorg

MesoStretch Marks Injection sites

Needle size

30/32 G x 4 mm 30/32 G x 6 mm 30/32 G x 12.7 mm

MesoGuns

Injection Techniques

PAPULE:

1 to 2mm, with bevel upwardsNAPPAGE:

2 to 4mm, angle of 30° to 60°POINT BY POINT:

deep injections, 4 to 12mm

Contraindications

Pregnancy, blood thinners, IDDM, cancer patients, AIDS patients, coronary artery heart disease or heart dysfunction, People with arrhythmias, history of blood clots or strokes, autoimmune diseases or organ transplant recipients and skin conditions including: herpes & psoriasis.

MESOPORATION

A new complex process utilizes the skin's water based "channels" to allow ionic drug solutions to penetrate into the skin, via controlled "electroporation - like" electrical pulses.

MESOPORATION

Applications are same as Mesotherapy.No needles are required.

MESOPORATION