Side effects of mesotherapy - review
DOI:
https://doi.org/10.12775/JEHS.2023.27.01.011Keywords
mesotherapy, microneedling, side effects, adverse reactions, complicationsAbstract
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.
References
Sarkar R, Garg VK, Mysore V. Position paper on mesothe-rapy. Indian J Dermatol Venereol Leprol. 2011 Mar-Apr; 77(2):232-7 doi:10.4103/0378-6323.77479
Marzban, Sima et al. “Safety and Efficacy of Mesotherapy in the Treatment of Androgenetic Alopecia: A Systematic Review.” (2017). April 2017 Health Technology Assessment in Action 1(2) doi:10.5812/htaa.14078
Plachouri KM, Georgiou S. Mesotherapy: Safety profile and management of complications. J Cosmet Dermatol. 2019 Dec;18(6):1601-1605. doi: 10.1111/jocd.13115. Epub 2019 Aug 24. PMID: 31444843.
Mammucari M, Russo D, Maggiori E, Paolucci T, Di Marzo R, Brauneis S, Bifarini B, Ronconi G, Ferrara PE, Gori F, Mediati RD, Vellucci R, Migliore A, Natoli S; Expert panel; Cancer Genome Center. Evidence based recommendations on mesotherapy: an update from the Italian society of Mesotherapy. Clin Ter. 2021 Jan-Feb;171(1):e37-e45. doi: 10.7417/CT.2021.2278. PMID: 33346324.
Sivagnanam G. Mesotherapy - The french connection. J Pharmacol Pharmacother. 2010 Jan;1(1):4-8. doi: 10.4103/0976-500X.64529. PMID: 21808584; PMCID: PMC3142757.
Markiewicz A, Zasada M, Erkiert-Polguj A, Wieckowska-Szakiel M, Budzisz E. An evaluation of the antiaging properties of strawberry hydrolysate treatment enriched with L-ascorbic acid applied with microneedle mesotherapy. J Cosmet Dermatol. 2019 Feb;18(1):129-135. doi: 10.1111/jocd.12545. Epub 2018 Apr 16. PMID: 29663691.
Wermeling DP, Banks SL, Hudson DA, Gill HS, Gupta J, Prausnitz MR, Stinchcomb AL. Microneedles permit transdermal delivery of a skin-impermeant medication to humans. Proc Natl Acad Sci U S A. 2008 Feb 12;105(6):2058-63. doi: 10.1073/pnas.0710355105. Epub 2008 Feb 4. PMID: 18250310; PMCID: PMC2538880.
Orjuela D, Puerto G, Mejía G, Castro C, Garzón MC, García LM, Hernández E, Ribón W, Rodríguez G. Cutaneous tuberculosis after mesotherapy: report of six cases. Biomedica. 2010 Jul-Sep;30(3):321-6. PMID: 21713332.
Centers for Disease Control and Prevention (CDC). Outbreak of mesotherapy-associated skin reactions--District of Columbia area, January-February 2005. MMWR Morb Mortal Wkly Rep. 2005 Nov 11;54(44):1127-30. PMID: 16280971.
Galmés-Truyols A, Giménez-Duran J, Bosch-Isabel C, Nicolau-Riutort A, Vanrell-Berga J, Portell-Arbona M, Seguí-Prat B, Gumá-Torá M, Martí-Alomar I, Rojo-Arias MÁ, Ruiz-Veramendi M. An outbreak of cutaneous infection due to Mycobacterium abscessus associated to mesotherapy. Enferm Infecc Microbiol Clin. 2011 Aug-Sep;29(7):510-4. doi: 10.1016/j.eimc.2011.03.006. Epub 2011 Jun 17. PMID: 21684045.
Wongkitisophon P, Rattanakaemakorn P, Tanrattanakorn S, Vachiramon V. Cutaneous Mycobacterium abscessus Infection Associated with Mesotherapy Injection. Case Rep Dermatol. 2011 Feb 18;3(1):37-41. doi: 10.1159/000324766. PMID: 21487459; PMCID: PMC3073751.
Da Mata Jardín O, Hernández-Pérez R, Corrales H, Cardoso-Leao S, de Waard JH. [Follow-up on an outbreak in Venezuela of soft-tissue infection due to Mycobacterium abscessus associated with Mesotherapy]. Enfermedades Infecciosas y Microbiologia Clinica. 2010 Nov;28(9):596-601. DOI: 10.1016/j.eimc.2009.08.003. PMID: 20106554.
Couderc C, Carbonne A, Thiolet JM, Brossier F, Savey A, Bernet C, Ortmans C, Lecadet-Morin C, Coudière I, Aggoune M, Astagneau P, Coignard B, Cambau E. Infections à mycobactéries atypiques liées à des soins esthétiques en France, 2001-2010 [Non-tuberculous mycobacterial infections related to esthetic care in France, 2001-2010]. Med Mal Infect. 2011 Jul;41(7):379-83. French. doi: 10.1016/j.medmal.2011.02.007. Epub 2011 Mar 25. PMID: 21440389.
Correa NE, Cataño JC, Mejía GI, Realpe T, Orozco B, Estrada S, Vélez A, Vélez L, Barón P, Guzmán A, Robledo J. Outbreak of mesotherapy-associated cutaneous infections caused by Mycobacterium chelonae in Colombia. Jpn J Infect Dis. 2010 Mar;63(2):143-5. PMID: 20332582.
Stéphanie Regnier and others, Clinical Management of Rapidly Growing Mycobacterial Cutaneous Infections in Patients after Mesotherapy, Clinical Infectious Diseases, Volume 49, Issue 9, 15 November 2009, Pages 1358–1364, https://doi.org/10.1086/606050
Quiñones, C et al. “An outbreak of Mycobacterium fortuitum cutaneous infection associated with mesotherapy.” Journal of the European Academy of Dermatology and Venereology : JEADV vol. 24,5 (2010): 604-6. doi:10.1111/j.1468-3083.2009.03461.x
Difonzo EM, Campanile GL, Vanzi L, Lotti L. Mesotherapy and cutaneous Mycobacterium fortuitum infection. Int J Dermatol. 2009 Jun;48(6):645-7. doi: 10.1111/j.1365-4632.2009.03487.x. PMID: 19538379.
Del-Castillo M, Palmero D, Lopez B, Paul R, Ritacco V, Bonvehi P, Clara L, Ambroggi M, Barrera L, Vay C. Mesotherapy-associated outbreak caused by Mycobacterium immunogenum. Emerg Infect Dis. 2009 Feb;15(2):357-9. doi: 10.3201/eid1502.081125. PMID: 19193300.
Veraldi S, Spigariolo CB, Cusini M, Nazzaro G, Gianotti R. Skin infections by Mycobacterium chelonae following mesotherapy: A report of two cases and review of the literature. J Cosmet Dermatol. 2020 Aug;19(8):1915-1917. doi: 10.1111/jocd.13441. Epub 2020 May 10. PMID: 32294290.
Rodríguez-Gutiérrez G, Toussaint S, Hernández-Castro R, Sánchez-León Mdel C, Arenas R. Nocardia brasiliensis infection: an emergent suppurative granuloma after mesotherapy. Int J Dermatol. 2014 Jul;53(7):888-90. doi: 10.1111/j.1365-4632.2012.05649.x. Epub 2013 Jul 8. PMID: 23829712.
. Gamo R, Aguilar A, Cuétara M, Gonzalez-Valle O, Houmani M, Martín L, Gallego MA. Sporotrichosis following mesotherapy for arthrosis. Acta Derm Venereol. 2007;87(5):430-1. doi: 10.2340/00015555-0271. PMID: 17721653.
Maiese A, Volonnino G, Viola RV, Nelson Cavallari E, Fazio V, Arcangeli M, La Russa R. A rare case of Spinal Epidural Abscess following mesotherapy: a challenging diagnosis and the importance of clinical risk management. Considerations concerning uncommon risk factor for development of Spinal Epidural Abscess and its prevention. Clin Ter. 2020 Jan-Feb;170(1):e15-e18. doi: 10.7417/CT.2020.2183. PMID: 31850479.
Moftah N, Moftah N, Abd-Elaziz G, Ahmed N, Hamed Y, Ghannam B, Ibrahim M. Mesotherapy using dutasteride-containing preparation in treatment of female pattern hair loss: photographic, morphometric and ultrustructural evaluation. J Eur Acad Dermatol Venereol. 2013 Jun;27(6):686-93. doi: 10.1111/j.1468-3083.2012.04535.x. Epub 2012 Apr 6. PMID: 22486925.
Arenbergerova M, Arenberger P, Gkalpakiotis S, Dahmen RA, Sticova E, Fialova A. Scalp melanoma after antihair loss mesotherapy. J Eur Acad Dermatol Venereol. 2018 May;32(5):e187-e188. doi: 10.1111/jdv.14690. Epub 2017 Dec 5. PMID: 29136296.
Kutlubay Z, Gokalp H, Ince U, Engin B. Cutaneous foreign body granulomas associated with lipolytic cocktail: Who is the enemy, mesotherapy or drugs injected? J Cosmet Laser Ther. 2017 Oct;19(5):310-312. doi: 10.1080/14764172.2017.1303167. Epub 2017 Mar 8. PMID: 28272912.
Alfaro‐Rubio A, Martorell‐Calatayud A, Pelufo C, Terradez L, Hueso‐Gabriel L, GarciaMelgares ML. Mesotherapy granulomas with L‐carnitine. American Academy of Dermatology 71st Annual Meeting. Florida, USA. 1‐5 March 2013. PP‐6919 (Poster). doi: 10.1016/j.jaad.2012.12.339
Gokdemir G, Küçükünal A, Sakiz D. Cutaneous granulomatous reaction from mesotherapy. Dermatol Surg. 2009 Feb;35(2):291-3. doi: 10.1111/j.1524-4725.2008.01053.x. PMID: 19215273.
Ramos-e-Silva M, Pereira AL, Ramos-e-Silva S, Piñeiro-Maceira J. Oleoma: rare complication of mesotherapy for cellulite. Int J Dermatol. 2012 Feb;51(2):162-7. doi: 10.1111/j.1365-4632.2011.04931.x. PMID: 22250624.
Strahan JE, Cohen JL, Chorny JA. Granuloma annulare as a complication of mesotherapy: a case report. Dermatol Surg. 2008 Jun;34(6):836-8. doi: 10.1111/j.1524-4725.2008.34156.x. Epub 2008 Mar 31. PMID: 18384371.
Lee DP, Chang SE. Subcutaneous nodules showing fat necrosis owing to mesotherapy. Dermatol Surg. 2005 Feb;31(2):250-1. doi: 10.1097/00042728-200502000-00027. PMID: 15762227.
Park EJ, Kim HS, Kim M, Oh HJ. Histological changes after treatment for localized fat deposits with phosphatidylcholine and sodium deoxycholate. J Cosmet Dermatol. 2013 Sep;12(3):240-3. doi: 10.1111/jocd.12053. PMID: 23992167.
El-Komy M, Hassan A, Tawdy A, Solimon M, Hady MA. Hair loss at injection sites of mesotherapy for alopecia. J Cosmet Dermatol. 2017 Dec;16(4):e28-e30. doi: 10.1111/jocd.12320. Epub 2017 Feb 3. PMID: 28160387.
Vaillant L, De Muret A, Muller C, Machet L, Lorette G. Toxidermie lichénoide après mésothérapie [Lichenoid drug eruption after mesotherapy]. Ann Dermatol Venereol. 1992;119(11):936-7. French. PMID: 1301729.
Grojean MF, Vaillant L. [Lichenoid eruption caused by mesotherapy]. Annales de Medecine Interne. 1995 ;146(5):365-366. PMID: 8526325.
Babacan, T., Onat, A.M., Pehlivan, Y. et al. A case of the Behcet’s disease diagnosed by the panniculits after mesotherapy. Rheumatol Int 30, 1657–1659 (2010). https://doi.org/10.1007/s00296-009-1123-0.
Rosina P, Chieregato C, Miccolis D, D'Onghia FS. Psoriasis and side-effects of mesotherapy. Int J Dermatol. 2001 Sep;40(9):581-3. doi: 10.1046/j.1365-4362.2001.01248-3.x. PMID: 11737454.
Bessis D, Guilhou JJ, Guillot B. Localized urticaria pigmentosa triggered by mesotherapy. Dermatology. 2004;209(4):343-4. doi: 10.1159/000080863. PMID: 15539904.
Colón-Soto M, Peredo RA, Vilá LM. Systemic lupus erythematosus after mesotherapy with acetyl-L-carnitine. J Clin Rheumatol. 2006 Oct;12(5):261-2. doi: 10.1097/01.rhu.0000239831.84504.0b. PMID: 17023815.
Calonge WM, Lesbros-Pantoflickova D, Hodina M, Elias B. Massive subcutaneous emphysema after carbon dioxide mesotherapy. Aesthetic Plast Surg. 2013 Feb;37(1):194-7. doi: 10.1007/s00266-012-0006-z. Epub 2013 Jan 8. PMID: 23296768.
Zaragoza J, Delaplace M, Benamara M, Estève E. Un effet indésirable rare de la mésothérapie : la dermite de Nicolau [A rare side effect of mesotherapy: Nicolau syndrome]. Ann Dermatol Venereol. 2013 Nov;140(11):713-7. French. doi: 10.1016/j.annder.2013.07.009. Epub 2013 Aug 6. PMID: 24206808.
Vukcević NP, Babić G, Segrt Z, Ercegović GV, Janković S, Aćimović L. Severe acute caffeine poisoning due to intradermal injections: mesotherapy hazard. Vojnosanit Pregl. 2012 Aug;69(8):707-13. Erratum in: Vojnosanit Pregl. 2012 Oct;69(10):929. PMID: 22924268.
Danilovic DL, Bloise W, Knobel M, Marui S. Factitious thyrotoxicosis induced by mesotherapy: a case report. Thyroid. 2008 Jun;18(6):655-7. doi: 10.1089/thy.2007.0233. PMID: 18578617.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Weronika Szwed, Alicja Nowak, Klaudia Bogusz, Natalia Baran, Marcela Maksymowicz, Adriana Bielak, Aleksandra Nowak, Łucja Cywka, Piotr Machowiec, Hubert Ciecierski-Koźlarek
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 977
Number of citations: 0
