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Mesotherapy in Dermatology , by Dr. Amr Ismail MD , Consultant Dermatologist.Mesotherapy in DepthNon-prescrition treatment modatlity.Non Conventional Safe Asethetic Procedure.Should rely on EBM.To achieve good results.Depend on Used Meostherapy Materials.Classification of Meostherapy MaterialsA. Principals :Ingredients that have been used orally or topically or injectablefor treatment of each indication/condition.Ingredients with high grade of evidence in treatment of each indication/condition.Ingredients that have been FDA Approved for treatment of each indication/condition.B. Complentary :Ingredients that have been claimed to improve the condition.Ideal Mesotherapy Materials / Cocktails :To achieve good results 80- 90 % , your used cocktails shouldcontain 2 -3 principals.
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MESOTHERAPY IN DERMATOLOGY
Dr. Amr Ismail MD
Consultant DermatologistMember 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
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
