MESOTHERAPY IN DERMATOLOGY
Dr. Amr Ismail MD Consultant Dermatologist
Member of American Academy of Aesthetic Medicine 19th May 2010 email:
[email protected] 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
Skin Structure
Embryonic origin Ectoderm Adult Derivative
Skin Epidermis Brain Breast Sweat glands Fibrous tissue (connective) Cartilage Bone Muscle Fat Gut Liver Lung Pancreas
Mesoderm
Endoderm
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 fibronectin GAG : Hyaluronic acid one of 7. Proteoglycans.
Mesotherapy
Connective Tissue Shock Therapy
How To Start
1.
2.
3. 4. 5.
Materials Injection sites Injection Depths Needle size 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 Materials Classification
A. Principals :
Ingredients that have been used orally or topically or injectable for treatment of each indication/condition.
Mesotherapy Materials Classification
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 Materials Classification
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 Principals Effluvium Biotin Hair (Vitamin H/B7) Growth Pantothenic Stimulants acid
(Vitamin B5)
Complementary
Pyridoxine (Vitamin B6) Zinc + Azelaic acid MV + MTE
I. Hair
AGA Principals Hair Growth Minoxidil Stimulants Finasteride
5-ARI
Dutasteride
Complementary
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
Dutasteride
Acts on the two isomers of the enzyme 5 alpha reductase thus it is effective in both males and females.
Finasteride
Acts against one isomer only isoenzyme II thus it is ineffective in females
Does not give any burning sensations during the injection The potency of dutasteride is greater than that of Finasteride
Very painful and give burning sensation
Lower potency than Dutasteride
MesoHair Protocols
Telogen Effluvium Biotin (P) Dexenol(P) MV + MTE (C) Androgenetic Alopecia Minoxidil(P) / Dutasteride(P) + Biotin(P) Dexenol(P) Zinc + Azelaic (C)
MesoHair Injection sites & depths
II. Face MesoLift / MesoGlow
Rejuvenation (Principals)
Hyaluronic acid Amino acids Vitamin C DMAE Organic Silicium Fibronectin + Vegetal proteins (Collagen & Elastin)
II. Face MesoLift / MesoGlow
Rejuvenation (Complementary)
Vitamin A Glycolic acid Taurine XADN MV & MTE
Rejuvenating Principals
1.
2.
Hyaluronic acid: maintain hydration + elasticity of skin Amino acids : improve skin tone+ firmness + elasticity. essential to compensate the reduced fibroblasts activity. Vitamin C : The only antioxidant that is proven to stimulate the synthesis of collagen
Rejuvenating Principals
1.
2.
DMAE : Potent firming acts quickly and lasts long. 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 Hyalift Silorgamine = Silorg + DMAE Puretinol / Vitamin A
Xadenal
Taurinox
MesoGlow Protocols
Fibronectin Elastine Collagen DMAE Vitamin C HA
Silorg
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 Glutathione Vitamin C Kojic acid
Vitamin C
with/without Hyaluronic / silorg
Glycolic acid
MesoLighten Injection sites & depths
MesoLighten Injection sites
MesoLighten Injection sites
MesoLighten
IV. Body Sculpting
Localized Fat. Cellulite. Stretch marks.
A. Localized Fat
LipoDissolve Injection Lipolysis
Localized Fat
ICCM / IAAL
Injection Lipolysis Mesotherapy
Deep 12mm PPC + DOC (PCDC) Hyaluronidase-CollagenaseArtichoke Intermediate 6mm (L-Carnitine-AminophyllineYohimbine- 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
Phosphatidylcholine Deoxycholic Acid Vitamin complex Alpha Lipoic Acid Amino Acids Phosphatidylcholine Deoxycholic Acid Taurine Organic silicium
Phosphatidylcholine Deoxycholic Acid L-Carnintine Aminophylline Pantothenic Acid
Localized Fat/ Injection Lipolysis Protocols
Phosphatidylcholine L-Carnitine Procaine
Phosphatidylcholine Caffeine Yohimbine 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 agents
Organic Silicium / Silorg Centella Asiatica Vegetal proteins + Fibronectin
Firming agents DMAE + Vitamin C DMAE + 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 upwards NAPPAGE: 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
