Who Should Avoid Mesotherapy? Top 10 Contraindications

Mesotherapy is a minimally invasive cosmetic procedure that involves injecting a mixture of vitamins, enzymes, hormones, and plant extracts into the mesodermal layer of the skin to promote skin rejuvenation, fat reduction, and hair growth. While mesotherapy has gained popularity due to its non-surgical nature and potential benefits, it is not suitable for all patients. Certain individuals may have contraindications or underlying conditions that make mesotherapy an unsafe or ineffective option. This article aims to provide a comprehensive overview of patients who should avoid mesotherapy, examining the reasons behind these exclusions, the potential risks, and alternative treatment options. This information is crucial for healthcare professionals to ensure patient safety and optimal outcomes.

Understanding Mesotherapy

Mesotherapy was first developed in 1952 by Dr. Michel Pistor in France for pain management. Over the years, its use has expanded to include aesthetic applications, such as:

• Skin Rejuvenation: Mesotherapy can improve the appearance of aging skin by enhancing hydration, firmness, and elasticity.
• Fat Reduction: It is used to target localized fat deposits, such as in the abdomen, thighs, buttocks, and chin, through lipolytic injections.
• Hair Loss Treatment: Mesotherapy may stimulate hair growth by improving blood circulation and delivering essential nutrients to the hair follicles.

The treatment typically involves multiple sessions and is tailored to the patient’s specific needs. However, despite its benefits, mesotherapy is not suitable for everyone.

Patients Who Cannot Take Mesotherapy

There are several groups of patients for whom mesotherapy is contraindicated or should be approached with caution. These include patients with certain medical conditions, those taking specific medications, and individuals with a predisposition to adverse reactions.

1. Patients with Active Infections or Inflammatory Skin Conditions
   • Rationale: Mesotherapy involves multiple injections, which can exacerbate existing infections or inflammation in the treated area. This can lead to the spread of infection, worsening inflammation, or delayed healing.
   • Examples: Conditions such as active acne, herpes simplex (cold sores), cellulitis, impetigo, or fungal infections are contraindications for mesotherapy.
   • Clinical Insight: It is crucial to ensure that any active infection or inflammatory condition is fully resolved before considering mesotherapy. In cases where patients have a history of recurrent herpes simplex, prophylactic antiviral therapy may be recommended.
2. Pregnant or Breastfeeding Women
   • Rationale: There is limited research on the safety of mesotherapy during pregnancy and breastfeeding. The substances used in mesotherapy may pose a risk to the fetus or nursing infant.
   • Potential Risks: Theoretical risks include teratogenic effects, fetal growth restriction, or adverse effects on breast milk production and composition.
   • Clinical Insight: Mesotherapy should be postponed until after pregnancy and breastfeeding to avoid any potential risks to the mother or child. Alternative treatments that are known to be safe during this period should be considered.
3. Patients with Autoimmune Diseases
   • Rationale: Autoimmune diseases involve an overactive immune response, and mesotherapy could potentially trigger an exacerbation or flare-up of the condition.
   • Examples: Conditions such as systemic lupus erythematosus (SLE), rheumatoid arthritis, scleroderma, and multiple sclerosis are considered contraindications for mesotherapy.
   • Clinical Insight: Patients with autoimmune diseases may experience an unpredictable immune response to the injections, including worsening of their condition or development of new autoimmune symptoms. A thorough assessment and consultation with a specialist are required before proceeding with mesotherapy.
4. Patients with Blood Clotting Disorders or Those on Anticoagulant Therapy
   • Rationale: Mesotherapy involves multiple needle punctures, which increase the risk of bleeding or hematoma formation, particularly in patients with coagulation disorders or those taking anticoagulants.
   • Examples: Conditions such as hemophilia, von Willebrand disease, and thrombocytopenia, as well as patients taking warfarin, heparin, or direct oral anticoagulants (DOACs), are contraindicated.
   • Clinical Insight: For patients on anticoagulant therapy, discontinuation of the medication may not be safe or feasible. Mesotherapy should be avoided in these cases to prevent excessive bleeding or bruising. An alternative treatment strategy should be considered.
5. Patients with Allergies to Mesotherapy Components
   • Rationale: Mesotherapy involves the injection of various substances, including vitamins, enzymes, plant extracts, and anesthetics. Allergic reactions to any of these components can result in local or systemic hypersensitivity reactions.
   • Examples: Allergic reactions may include urticaria, angioedema, anaphylaxis, or delayed-type hypersensitivity reactions.
   • Clinical Insight: A thorough allergy history is essential before considering mesotherapy. A patch test or intradermal test may be conducted to identify potential allergens. If any allergic reaction is identified, mesotherapy should be avoided or modified to exclude the offending agent.
6. Patients with Uncontrolled Diabetes Mellitus
   • Rationale: Diabetes, particularly when uncontrolled, can impair wound healing and increase the risk of infection. The multiple needle punctures involved in mesotherapy can act as an entry point for pathogens, leading to complications.
   • Potential Risks: Diabetic patients are at an increased risk for delayed wound healing, infection, and poor cosmetic outcomes due to their compromised immune response.
   • Clinical Insight: It is important to ensure that a patient’s blood glucose levels are well-controlled before proceeding with mesotherapy. In cases of poorly controlled diabetes, alternative treatments that pose less risk should be explored.
7. Patients with Keloid or Hypertrophic Scar Tendencies
   • Rationale: Individuals who have a history of keloid formation or hypertrophic scarring may be at risk of developing these scars in response to the microtrauma caused by mesotherapy injections.
   • Potential Risks: Keloids or hypertrophic scars can result in aesthetically displeasing outcomes and may require further treatment, such as corticosteroid injections or laser therapy.
   • Clinical Insight: For patients with a known history of abnormal scar formation, alternative treatments that do not involve skin puncture should be considered. If mesotherapy is deemed necessary, it should be performed with caution and under close monitoring.
8. Patients with Active Malignancies
   • Rationale: Mesotherapy is contraindicated in patients with active malignancies due to the potential risk of stimulating tumor growth or metastasis.
   • Examples: Any active cancer, whether localized or metastatic, represents a contraindication for mesotherapy.
   • Clinical Insight: In patients with a history of cancer, it is important to ensure that the cancer is in remission before considering mesotherapy. A thorough evaluation and clearance from the oncologist are necessary.
9. Patients with Chronic Inflammatory Diseases
   • Rationale: Chronic inflammatory diseases, such as inflammatory bowel disease (IBD) or chronic obstructive pulmonary disease (COPD), can lead to unpredictable responses to mesotherapy, potentially worsening the underlying condition.
   • Examples: Conditions such as Crohn’s disease, ulcerative colitis, and rheumatoid arthritis may be exacerbated by mesotherapy.
   • Clinical Insight: A careful risk-benefit analysis should be performed before considering mesotherapy in patients with chronic inflammatory diseases. Close collaboration with the patient’s primary care physician or specialist is essential.
10. Patients with Psychological Disorders

• Rationale: Patients with certain psychological disorders, such as body dysmorphic disorder (BDD) or severe anxiety, may have unrealistic expectations or an exaggerated response to the discomfort associated with mesotherapy.
• Potential Risks: Psychological distress, dissatisfaction with results, or worsening of underlying psychological conditions.
• Clinical Insight: A thorough psychological evaluation is recommended for patients with known psychological disorders before proceeding with mesotherapy. If any concerns are identified, psychological support or alternative treatment approaches should be considered.

Risks and Complications of Mesotherapy

Understanding the risks and potential complications of mesotherapy is crucial for determining patient eligibility:

• Local Reactions: Pain, swelling, erythema, bruising, and infection at the injection site.
• Systemic Reactions: Allergic reactions, including anaphylaxis, particularly in patients with a history of allergies.
• Scarring: Risk of hypertrophic scars or keloids in predisposed individuals.
• Pigmentary Changes: Post-inflammatory hyperpigmentation or hypopigmentation, particularly in patients with darker skin tones.

Alternative Treatment Options

For patients who cannot undergo mesotherapy, alternative treatment options should be considered based on the patient’s specific needs and goals:

1. Topical Treatments: Various topical agents, including retinoids, peptides, and hyaluronic acid, can improve skin texture and hydration.
2. Laser Therapy: Fractional laser, intense pulsed light (IPL), and radiofrequency treatments can target skin rejuvenation, pigmentation, and hair growth.
3. Chemical Peels: Superficial to medium-depth chemical peels can improve skin tone and texture without the need for injections.
4. Microneedling: While still minimally invasive, microneedling may be an option for patients without contraindications, aiming to improve skin texture and promote collagen production.
5. Platelet-Rich Plasma (PRP) Therapy: PRP involves injecting the patient’s own platelet-rich plasma to promote healing and rejuvenation, with fewer risks compared to mesotherapy.

Conclusion

Mesotherapy is a versatile and minimally invasive procedure that offers several aesthetic and therapeutic benefits. However, it is not suitable for all patients. Identifying those who should avoid mesotherapy is crucial to prevent complications and ensure patient safety. Healthcare professionals must thoroughly evaluate each patient’s medical history, current health status, and specific contraindications before recommending mesotherapy. Alternative treatment options should be considered for those who cannot undergo this procedure, tailored to their unique needs and conditions.