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The skin we live in. Part 3

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esotherapy (from Greek mesos – "middle") is a non-surgical cosmetic medicine treatment. It employs multiple small dose injections of pharmaceutical medications, hyaluronic acid, vitamins, and other ingredients, into the dermis and hypodermis. In these skin layers, the blood vessels, immune defense cells, and the cells responsible for collagen and elastin synthesis are located. In recent years, mesotherapy is one of the most popular treatments in cosmetic clinics. Advertising is full of reports about its undoubted benefits and absolute harmlessness. In beauty salons, would tell you that this method is not new, that mesotherapy has already been used successfully since the middle of the 20th century.

Does it seem that there is a miracle treatment meant to prolong healthy and youthful skin? We can examine further the feasibility of mesotherapy and all of its’ promoted advantages in terms of physiology.

We’ll start with the fact that at this time, no clinical studies are proving the effectiveness of this correction method for age-related changes (we are talking about scientific research, which meets the requirements of evidence-based medicine).

Cosmetologists who practice this technique say that applying active substances inside the dermis is more effective than using them topically. In addition, those cosmetologists maintain the position that the multiple micro-injuries of the skin surface caused by the injections will enhance blood circulation in the subcutaneous layer. The skin cells receive a powerful boost to rejuvenation, and cellular regeneration is accelerated.
While these multiple punctures may increase blood circulation, there are other risks and complications that you aren’t told about it.

Dangerous bacteria can penetrate the human body through the damaged skin, causing an allergic reaction with subsequent inflammation, followed by scar tissue formation or hyper- and hypopigmentation. Repetitive damage to the epidermis, blood vessels, and nerve endings may cause the formation of antibodies and skin hypersensitivity. Necrosis and skin abscesses, lupus erythematosus, urticaria, psoriasis, and mycobacterial infections could be on the list of frequent complications.
Additionally, pharmaceutical companies are involved in the "beauty race", constantly replenishing the list of allegedly "allowed and safe" ingredients for the injections. Alas, how these chemical compounds will affect your skin is impossible to predict.

We should not forget that the beauty industry is a business. For the owners of clinics and practicing beauticians, the mesotherapy procedure is very beneficial in financial terms. While it requires a minimum amount of medications and the most straightforward equipment, the course of treatment is quite extensive, requiring constant (or frequent ) repetition.

What happens to our skin tissues after the administration of these therapeutic "magic mixtures"? Perhaps, the most popular substance for the injections is hyaluronic acid. Recall that the main feature of hyaluronic acid, produced by your skin, is the ability to bind and retain water. However, being injected under the skin unnaturally, the hyaluronic acid has moisture in the middle layers of the dermis. It increases pressure on the capillary network, reduces the volume of intravascular fluid, breaks the capillaries, and slows the metabolic processes.

Due to excessive pressure on the blood vessels, edema develops inevitably. The edema can decrease after the body's enzymes break down and remove all the foreign molecules from the body. Edema development, caused by the extraneous hyaluronic acid debris, will progress in a vicious cycle. Thus, due to defense reactions in the skin, the blood and oxygen circulation disorders in the connective tissue disorders arise gradually, and the metabolism and cell regeneration slow down. Moreover, analysis of electron-microscope investigations shows a decrease in the diameter of collagen fibers after mesotherapy treatments. As we know, the quantity and quality of collagen fibers in the skin directly affect its elasticity and resistance to mechanical actions.

From the above, we can conclude that tissue hydration can achieve temporary visual improvement of skin conditions. Still, a side effect of such intervention is always an impetus to rapid aging.

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Another so-called advantage of mesotherapy is the subcutaneous injection of vitamins, minerals, and amino acids. On a practical level, all of the ingredients contained in the injections are hydrophilic or water-soluble. And you know what? The subcutaneous fat is unable to deposit such substances! In its "storage", the subcutaneous fat can hold only fat-soluble components, representing a specific biological form. Vitamins and minerals should come into our body orally, and our body is responsible for their transformation into biochemically active forms in the liver. Therefore, the skin doesn't need to be traumatized with unproductive injections.

Platelet-Rich Plasma Therapy, or PRP-therapy, is the prevalent (and, by the way, costly) mesotherapy method. In this method, the blood plasma that has been enriched with platelets is inserted under the skin. This preparation is made of the patient's venous blood passed through a particular spin machine. In this machine, called sedimentation, the platelet-rich plasma gets separated from the other blood cells. Figuratively speaking, in the body, platelets serve as an "ambulance" and "intensive care". They gather in the damaged or wounded area; they form a blood clot and trigger a cascade of the wound-healing biochemical reactions. Then, the platelets secrete the growth factors, which stimulate cell movement and updating of the structures. In addition, these factors activate the process of formation of new blood vessels. This process, described above, occurs in our body right after the "beauty injection": it signals to our body that the skin is out of order, and it must start rebuilding urgently.

Of course, if the cosmetologist damages the patient’s skin repeatedly, the natural healing effect of platelets can improve the color and turgor of the aging skin. Beauticians put their hopes upon these effects regarding the usage of PRP therapy in anti-aging cosmetology. On the other hand, the same results can be achieved by chemical peeling, applied in low concentrations. So why on earth should one stand the traumatic procedures of blood sampling and subcutaneous injections if there are more natural ways of rejuvenation?

PRP therapy requires the constant repetitions of the supporting treatment courses. It can increase the risk of stress in the immunity system and then deplete the immune reserve. The energy for the recovery process is drawn from the “emergency stocks” of our bodies. Mother Nature laid these stocks for the entire stage of life. This method works only as temporary doping. Sooner or later, the body will stop responding to this intervention.

Any injection technique has the risk of infectious complications. In addition, multiple and regular skin injury leads to tissue scarring. So far, it’s impossible to avoid complications: there is no surgery without risks, as there is no completely safe method of mesotherapy drug administration.

So, let's weigh the "pros" and "cons". On the one hand, mesotherapy procedures can help to achieve a temporary improvement of the skin appearance. On the other hand, this improvement will cause apparent stimulation of aging and the long-term trophic changes of the skin. Moreover, this kind of treatment still does not have the proven efficiency. The price we pay in a rush towards the passing beauty is too high. It is not worth risking your health and the vital resources of the body. There are dozens of healthy methods of maintaining and restoring your skins' appearance, and your body will accept it with joy and gratitude. Natural cosmetics, massages and peelings, facial exercises, proper nutrition, fresh air, physical activity, healthy sleep, bright smile, and positive thinking do wonder. Love yourself and be beautiful!

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Деев А.И., Шарова А.А., Брагина И.Ю. Под общей редакцией Эрнандес Е.И. Новая косметология "Аппаратная косметология и физиотерапия", 2014 г.
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