Mesoterapia: uma revisão bibliográfica

Abstract

Intradermotherapy is a medical procedure introduced by Pistor in 1958 that consists in the application of intradermal injections of diluted pharmacological substances that are given directly into the region to be treated. There are reports of the use of intradermotherapy to treat painful diseases, skin diseases and unaesthetic conditions. Medical clinics have been recently offering the treatment of intradermotherapy, using the more popular name for this practice -mesotherapy. There is only scant scientific information about this subject published in periodicals indexed on MedLine. Only a few states rigorously pursue this method. Most indexed publications about this subject deal with the complications of this technique. Unaesthetic dermatoses have been a common complaint in dermatologic clinics, and it has become necessary to have scientific evidence to give to patients. Therefore, well-researched scientific studies about this technique are necessary to offer data to medical professionals that will clearly explain to patients both the benefits and the risks of these procedures. A bibliographical review was conducted and we verified the need for new studies with adequate methods to confirm the benefits of intradermotherapy as used in dermatologic treatment. Keywords: Injections, intradermal; Review; Skin; Therapeutics Resumo: A intradermoterapia é um procedimento médico introduzido por Pistor, em 1958, e consiste na aplicação, diretamente na região a ser tratada, de injeções intradérmicas de substâncias farmacológicas muito diluídas. Esse método é capaz de estimular o tecido que recebe os medicamentos tanto pela ação da punctura quanto pela ação dos fármacos, e apregoa-se que sua vantagem é evitar o uso de medicação sistê-mica. Há relatos da utilização da intradermoterapia para tratamento de doenças dolorosas, dermatoses e condições consideradas inestéticas. Atualmente, clínicas médicas oferecem esse tratamento, utilizando, porém, o nome mais popular para essa prática, mesoterapia. Há escassa informação científica sobre o tema publicada em periódicos indexados no MedLine e poucos estudos com metodologia mais rigorosa sobre a eficácia e o mecanismo de ação da via intradérmica. A maioria das publicações indexadas sobre esse tema versa sobre as complicações dessa técnica. As dermatoses inestéticas têm se tornado queixas frequentes nos consultórios dermatológicos, sendo necessário um embasamento científico para lidar com tais pacientes, os quais, muitas vezes, estão em busca das novidades mostradas através da mídia. Assim, há necessidade de estudos cientificamente bem conduzidos sobre essa técnica. Estes estudos deverão oferecer aos médicos elementos para esclarecer os pacientes sobre quais benefícios esperar e quais os riscos de tal abordagem. Desse modo, realizou-se uma revisão bibliográfica sobre o assunto e constatou-se a necessidade de novos estudos com metodologia adequada para a confirmação dos benefícios da intradermoterapia como ferramenta útil no tratamento dermatológico.

Role of Mesotherapy in Musculoskeletal Pain: Opinions from the Italian Society of Mesotherapy

“…These results were confirmed with the intradermal inoculation of procaine and penicillin G [24, 25]. Similar results were demonstrated in human studies following intradermal injection (up to 4 mm), and interestingly results confirmed that when a drug is injected at a depth of more than 10 mm it remains for a short time in the surrounding tissues and reaches the systemic circulation rapidly [6]. …”

“…The use of a single drug appears to reduce the risk of drug-drug interactions and local side effects, and the risk of infection is avoided if correct ascetic procedures are employed [5]. Literature reports that the subcutaneous infections [6, 71] seem to be caused by external contamination and malpractice rather than to the technique itself.…”

“…It is vital that the procedure is carried out using strictly controlled aseptic techniques and that proper hygiene and sterilization procedures are employed. As a result of the use of this procedure by nonmedical personnel, the failure to comply with hygiene standards, incorrect administration techniques and the misuse of drugs (medications mixed together), a number of adverse events have been reported in the medical literature, in particular due to the lack of aseptic conditions [6]. Furthermore, the lack of randomized clinical trials has raised certain doubts on the validity of this technique [7, 8].…”

In vitro study of RRS HA injectable mesotherapy/biorevitalization product on human skin fibroblasts and its clinical utilization

“… 1 The term “meso” from mesotherapy comes from the Greek word “mesos” referring to the mesoderm (or middle germ cell layer) in the early embryo, which differentiates into tissues and structures, including bone, cartilage, muscle, and connective tissue. 2 …”

El costo de la belleza: Comunicación de seis casos clínicos con infección por micobacterias atípicas secundario a inyecciones intradérmicas y reacción a un dermoimplante de origen desconocido

“…Estos procedimientos no siempre se realizan siguiendo estándares de seguridad e higiene, e incluso son realizados por personal no médico. También es frecuente la aplicación de otras sustancias con las misma técnica, que no están aprobados por entes reguladores y sin registro sanitario 1 .…”