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Mesotherapy (from Greek ''mesos'', "middle", and therapy from Greek ''therapeia'') is a form of
alternative medicine Alternative medicine refers to practices that aim to achieve the healing effects of conventional medicine, but that typically lack biological plausibility, testability, repeatability, or supporting evidence of effectiveness. Such practices are ...
which involves
intradermal Intradermal injection (also intracutaneous or intradermic, abbreviated as ID) is a shallow or superficial injection of a substance into the dermis, which is located between the epidermis and the hypodermis. For certain substances, administration ...
or subcutaneous injections of pharmaceutical preparations, enzymes, hormones, plant extracts, vitamins, and/or other ingredients such as
hyaluronic acid Hyaluronic acid (; abbreviated HA; conjugate base hyaluronate), also called hyaluronan, is an anionic, nonsulfated glycosaminoglycan distributed widely throughout connective, epithelial, and neural tissues. It is unique among glycosaminog ...
. It has no proven clinical efficacy and poor scientific backing. Mesotherapy injections allegedly target
adipose Adipose tissue (also known as body fat or simply fat) is a loose connective tissue composed mostly of adipocytes. It also contains the stromal vascular fraction (SVF) of cells including preadipocytes, fibroblasts, Blood vessel, vascular endothel ...
fat cells, apparently by inducing
lipolysis Lipolysis is the metabolic pathway through which lipid triglycerides are hydrolysis, hydrolyzed into a glycerol and free fatty acids. It is used to mobilize stored energy during fasting or exercise, and usually occurs in Adipose tissue, fat adip ...
, rupture and
cell death Cell death is the event of a biological cell ceasing to carry out its functions. This may be the result of the natural process of old cells dying and being replaced by new ones, as in programmed cell death, or may result from factors such as di ...
among
adipocyte Adipocytes, also known as lipocytes and fat cells, are the cell (biology), cells that primarily compose adipose tissue, specialized in storing energy as fat. Adipocytes are derived from mesenchymal stem cells which give rise to adipocytes through ...
s. The stated aim of mesotherapy is to provide the skin with essential nutrients, hydration, and other beneficial compounds to rejuvenate and revitalize its appearance. The effects of the treatment may vary depending on the individual. Pressurized mesotherapy is a needle-free method that uses an accelerated jet of air to insert the ingredients into the skin tissue. A study on the effect of using a lipolytic substance inserted with needles compared to pressurized injection showed significant fat layer reduction for both methods but even better results with the pressurized injection system.


Usage

In the United States, deoxycholic acid, under the brand name Kybella, is approved by the
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...
for reducing moderate-to-severe fat below the chin. When injected into submental fat, deoxycholic acid helps destroy adipocytes (fat cells), which are metabolized by the body over the course of several months. Deoxycholic acid has not been approved for injection elsewhere in the body. There is no conclusive research proof that any chemical compounds work to target adipose (fat cells) specifically. Cell
lysis Lysis ( ; from Greek 'loosening') is the breaking down of the membrane of a cell, often by viral, enzymic, or osmotic (that is, "lytic" ) mechanisms that compromise its integrity. A fluid containing the contents of lysed cells is called a ...
, resulting from the detergent action of deoxycholic acid, may account for any clinical effect.


History

Michel Pistor (1924–2003) performed clinical research and founded the field of mesotherapy. The French press coined the term mesotherapy in 1958. The French Académie Nationale de Médecine recognized mesotherapy as a specialty of medicine in 1987. The French Society of Mesotherapy recognizes its use as treatment for various conditions but makes no mention of its use in plastic surgery. Popular throughout European countries and South America, mesotherapy is practiced by approximately 18,000 physicians worldwide.


Market Trends

The global mesotherapy market is projected to grow from approximately US$664 million in 2024 to over US$1.3 billion by 2031, with a compound annual growth rate (CAGR) of 10.4% between 2025 and 2031. The increasing demand for non-invasive aesthetic procedures, such as skin rejuvenation, fat reduction, and hair restoration, is a key driver of this growth. Advancements in mesotherapy technologies—such as no-needle and automated injection systems—have improved treatment precision, patient comfort, and safety. These innovations have made mesotherapy more accessible to dermatologists and cosmetic professionals worldwide. In addition, the rising influence of social media and celebrity endorsements has contributed to the popularity of cosmetic procedures, particularly among younger demographics. Regional markets in North America and Europe currently dominate, while countries in Asia-Pacific, including China, India, and South Korea, are experiencing rapid growth due to changing beauty standards, increasing urbanization, and higher disposable incomes. The development of customized mesotherapy cocktails containing hyaluronic acid, peptides, and vitamins has also expanded treatment capabilities. These formulations target a range of skin concerns, including aging, pigmentation, and hair loss.


Criticism

Physicians have expressed concern over the efficacy of mesotherapy, arguing that the treatment hasn't been studied enough to make a determination. Mesotherapy for the treatment of cosmetic conditions hasn't been the subject of standard clinical trials; however, the procedure has been studied for pain relief for several ailments, such as
tendonitis Tendinopathy is a type of tendon disorder that results in pain, swelling, and impaired function. The pain is typically worse with movement. It most commonly occurs around the shoulder ( rotator cuff tendinitis, biceps tendinitis), elbow ( tenn ...
, tendon calcification, dental procedures,
cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...
, cervicobrachialgia,
arthritis Arthritis is a general medical term used to describe a disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, Joint effusion, swelling, and decreased range of motion of ...
,
lymphedema Lymphedema, also known as lymphoedema and lymphatic edema, is a condition of localized edema, swelling caused by a compromised lymphatic system. The lymphatic system functions as a critical portion of the body's immune system and returns inters ...
, and venous stasis. Despite the lack of clinical trials, there have been case studies and medical papers written on mesotherapy as a cosmetic treatment. Rod Rohrich, M.D., chairman of the Department of Plastic Surgery at the
University of Texas Southwestern Medical Center The University of Texas Southwestern Medical Center (UT Southwestern or UTSW) is a public academic health science center in Dallas, Texas. With approximately 23,000 employees, more than 3,000 full-time faculty, and nearly 4 million outpatient ...
is quoted as saying: "There is simply no data, no science and no information, to my knowledge, that mesotherapy works." The
American Society of Plastic Surgeons The American Society of Plastic Surgeons (ASPS) is a professional society that represents plastic surgeons in the United States and Canada Canada is a country in North America. Its Provinces and territories of Canada, ten provinces a ...
issued a position statement not endorsing mesotherapy. In the United States, the
FDA The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
cannot control the act of practitioners injecting various mixtures into patient's bodies, because this practice falls under the jurisdiction of state medical boards. Robin Ashinoff, speaking for the
American Academy of Dermatology The American Academy of Dermatology (AAD) is a non-profit professional organization of dermatologists in the United States and Canada, based in Rosemont, Illinois, near Chicago. It was founded in 1938 and has more than ''21,000'' members. The Acad ...
, wrote "A simple injection is giving people false hope. Everybody's looking for a quick fix. But there is no quick fix for fat or fat deposits or for cellulite." The American Society for Dermatologic Surgery informed its members in February 2005 that "further study is warranted before this technique can be endorsed." "No one says exactly what they put into the (syringe)," said Naomi Lawrence, a derma-surgeon at the University of Medicine and Dentistry of New Jersey. "One drug they often use,
phosphatidylcholine Phosphatidylcholines (PC) are a class of phospholipids that incorporate choline as a headgroup. They are a major component of biological membranes and can easily be obtained from a variety of readily available sources, such as egg yolk or soyb ...
, is unpredictable and causes extreme inflammation and swelling where injected. It is not a benign drug." Mesotherapy is currently banned in a number of South American countries. Even Brazil, which tends to be less strict than the US in drug approvals, has banned the drug for these purposes. In Australia, an alternative therapy salon was investigated by the Health Department after several clients developed skin abscesses on the calves, buttocks, thighs, abdomen, shoulders, face and neck after undergoing mesotherapy, with one patient also developing a
mycobacterial ''Mycobacterium'' is a genus of over 190 species in the phylum Actinomycetota, assigned its own family, Mycobacteriaceae. This genus includes pathogens known to cause serious diseases in mammals, including tuberculosis ('' M. tuberculosis'') an ...
infection. Following undesirable effects observed on several patients of a French practitioner, an official
ratification Ratification is a principal's legal confirmation of an act of its agent. In international law, ratification is the process by which a state declares its consent to be bound to a treaty. In the case of bilateral treaties, ratification is usuall ...
was published in France in April 2011 to ban mesotherapy as a method for removing fat deposits. This ban was canceled in June 2011 by the French Council of State because the investigation proved that these undesirable effects weren't due to mesotherapy itself, but were due to unhygienic conditions.


Clinical studies

In a prospective study, 10 patients underwent four sessions of facial mesotherapy using multivitamins at monthly intervals. This study found that there was no clinically relevant benefit for skin rejuvenation. Deoxycholic acid received FDA approval as an injectable to dissolve submental fat June 2015. This was based on the results of a phase III randomized trial of 2600 patients in which 68.2% of patients showed a response by measurement of the fat deposit; 81% had mild temporary adverse reactions of bruising, swelling, pain, numbness, erythema, and firmness around the treated area.


References


External links


American Board of Aesthetic MesotherapyFrench Society of MesotherapyProfessional Board of Mesotherapy Atlanta
{{Webarchive, url=https://web.archive.org/web/20160325155705/http://www.mesotherapyatlanta.com/ , date=2016-03-25 Cosmetics Alternative medical treatments Pseudoscience 1950s neologisms French inventions