Mesoterapia Revisión

REVIEW ARTICLE 129

Mesotherapy
Thada Piamphongsant

■Mesoderm is a middle layer of tissue formed
in the early developing embryo. Therefore the treatment at this skin layer is called mesotherapy. However the treatments sometimes extended to the superficial layer or deeper through internal organs. Thus, to understand the details of such therapy, we need to have an overview of thetreatmentûs principle. To administer drugs through the skin and lower tissue layer, several medias are needed. A) Skin moisturization such as to moisture the skin with water or emollient, to cover by transparent plastics, or to use drug delivery patch which has occlusive effect. B) Chemical mixture such as DMSO, isopropyl myristate, propylene glycol. These chemicals will act as a penetration enhancers. C)Advance technology adapted to improve the penetration effect of the media. For example, the drug capsule is specially designed to have better penetration property or using some techniques to minimize the

molecules of drugs such as liposome, nanosome. D) To change the condition of epidermis by using electromagnetic wave, microneedles or penetration of the drug through hair follicles. E)Application of electrical techniques, i.e. ionto, phono, sono or electromagnetic method. In dermatological study, magnesium ascorbyl phosphate cannot penetrate directly through the skin. It has to be modified by or combined with other methods e.g. iontophoresis-it has a synergistic effect on superficial melasma but not effective in deeper type. However superficial melasma can be cured by any bleachingcreams and there is no need to use iontopheresis. In cosmetic dermatology vitamin C is generally used to treat melasma, however there is some limitation due to its fast deteriorating property. Though there are attempts using various technologies to stabilized vitamin C, the longest duration only lasts for 3 months. Stabilized vitamin C are used instead such as ascorbyl tetra-iso palmitate, orenveloped in

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REVIEW ARTICLE 130

glycosphere. The selection of base substances is also important as it has an influence in the penetration of vitamin. It was found that vitamin C in oil-in-water base has better penetration than in water-in-oil base and to be in gel form is better than in cream.1 It was found that only a part of vitamin Cstructure is important to fibroblast but it was not possible for fibroblast to incorporate vitamin C. Fullerence-enveloped vitamin C which has similar structure to nanosphere might help in the penetration process. Fifty years ago due to poor penetration into the skin, some French doctors thought of why not inject vitamin C into the skin? Nowadays patients quest for the treatment methods. What they wantare safe methods, no complication, no anesthetic, simple for both physicians and patients. But most of all it must be effective, fast and not expensive. Therefore anesthetic mesotherapy seems to answer the question. Mesotherapy is an advance technique of injection. Multiple injections at a time can be done with minimum pain. Drugs to be used can be varied depending on the pathology of diseases.Principles of mesotherapy are2 Right drug Right dose (not for which can create problems), and Right location (suitable depth) For example : ● Use of multivitamin, and hyaluronic acid for wrinkles. ● Use of botox for shallow wrinkle, so called mesobotox. Actually botox injection is a kind of

mesotherapy. Technique Special needles are needed for mesotherapy injection, which are for the depth of4, 6 and 13 mm. At the beginning, botox injection was more popular than that of mesotherapy, so the latter was used for other locations that botox could not be used by dissolving the drug at 5 times dilution. If using the standard botox injection, it may cause twisted face. ● There are 3 main drug groups used for getting rid of cellulite as follow : 1) The group that its effect is to increase...