Frontal edema due to mesotherapy for androgenetic alopecia: A case series

Abstract

Androgenetic alopecia (AGA) is the most common form of non-cicatricial alopecia in both genders. Currently approved drugs for the treatment of AGA include topical minoxidil in women and topical minoxidil and oral finasteride in men. Other routes of administration of approved drugs have been proposed to enhance therapeutic results for AGA, including intradermal injections, known as mesotherapy. Mesotherapy-or intradermotherapy-is a non-surgical procedure, consisting of multiple intradermal injections of pharmacological substances diluted in small doses. Although minimally invasive, mesotherapy may be related to mild side effects like burning, erythema and headaches, as a few reports indicate. Among the most serious adverse events, subcutaneous necrosis, scalp abscesses, and angioedema have been described. This multicenter retrospective, descriptive study aims to report 14 cases of frontal edema resulting from mesotherapy for AGA treatment. In our patients, the edema mostly arose in the first two sessions and lasted between 1 and 4 days, with a favorable outcome after a local cold compress. In all our cases of edema, lidocaine was the anesthetic used. Minoxidil and dutasteride might also play a role as causative agents. To the best of our knowledge, this is the largest case series focused on frontal edema after mesotherapy for AGA and gives clinicians helpful information for when performing this technique. Dermatologists should already consider and be conscious of this possible mesotherapy side effect, as it can be remarkably disruptive to affected patients.

Minimally invasive procedures for the management of female pattern hair loss

“…Recently, Melo et al described frontal edema as a side effect of mesotherapy using minoxidil and dutasteride in 14 patients. These drugs might have played a role as causative agents for the edema, or the excessive total volume injected in one session could also be an explanation 15 …”

“…14 In addition to local pain and mild headache, some complicationssuch as mycobacterial infection, urticaria, skin necrosis, panniculitis, achromia, and scarring alopecia-have also been reported. 15 However, most of them are likely related to incorrect indications, improper asepsis, and procedures performed by non-medical professionals. 11,15 Recently, Melo et al described frontal edema as a side effect of mesotherapy using minoxidil and dutasteride in 14 patients.…”

“…15 However, most of them are likely related to incorrect indications, improper asepsis, and procedures performed by non-medical professionals. 11,15 Recently, Melo et al described frontal edema as a side effect of mesotherapy using minoxidil and dutasteride in 14 patients. These drugs might have played a role as causative agents for the edema, or the excessive total volume injected in one session could also be an explanation.…”

“…These drugs might have played a role as causative agents for the edema, or the excessive total volume injected in one session could also be an explanation. 15 The evidence supporting synthetic growth factors in mesotherapy is still scarce. Reports of melanoma after their use for telogen effluvium raise questions about its safety.…”

Mesotherapy as a Promising Alternative to Minoxidil for Androgenetic Alopecia: A Systematic Review

“…In comparison, the case series of Melo et al [ 13 ] and Magdaleno-Tapial et al [ 14 ], which included 15 patients in total, focused on the complications and limitations associated with using mesotherapy. Magdaleno-Tapial et al [ 14 ] discussed the case of a 45-year-old lady who had significant facial edema and erythema 24 hours after her first mesotherapy with dutasteride for AGA.…”