The Evolution of Skin Injection Therapy Methods

Mesotherapy: a current classic

The basis of injection cosmetology is the mesotherapy method. Developed by French physician Michel Pistor in 1958, it revolutionized cosmetology.

What is mesotherapy? As the name suggests, this is a treatment based on numerous injections of microdoses of individual medications and their mixtures, both locally and at some distance from the affected area. It is this introduction of drugs that allows one to overcome the natural barriers of the body - the skin and mucous membranes, and to carry out targeted delivery of drugs to the affected organ and tissue. Given the significant trauma, the method provokes processes similar to those that occur with skin wounds, but on a smaller scale.

As a result of cell damage, biologically active substances are released that catalyze various reactions: on the one hand, metabolic processes are intensified, on the other – regenerative processes, which are aimed at restoring the structure of the intercellular matrix. For mesotherapy, special techniques have been developed that make it possible to inject drugs into different layers of the dermis (nappage, papular, tubercular, classical, linear-retrograde) and somewhat deeper into the hypodermis (infiltration). Using this method, we have a unique opportunity to work locally and regionally, using minimal doses of active ingredients to influence the metabolism and structure of the skin and subcutaneous tissue. The presence of a pharmacological component expands and enhances the effect of microtrauma, leading to positive results not only for rejuvenation purposes, but also for many nosological conditions. Thus, with the help of mesotherapy, you can cure a disease, get rid of excess weight, reduce the severity of hyperpigmentation, restore lost turgor to the skin, strengthen the immune system, eliminate the negative effects of stress, etc.

Unique possibilities of mesotherapy:

• implementation of targeted delivery of necessary elements to the right areas and selection of compounds that will be well absorbed by the skin;
• the activity of substances does not depend on the degree of their absorption in the intestines, as with oral administration;
• reducing the load on the excretory organs;
• creation of a substance depot in the skin, prolonged pharmacological effect;
• optimization of the result, based on knowledge of the synergism-antagonism of essential vitamins and microelements, as well as their interaction with drugs.

A big advantage of mesotherapy is its “ability to work” with the microvascular bed. Our body is designed in such a way that intradermal capillary networks are closely connected with the vital activity of all structural components of the skin. As soon as for any reason the capillaries stop working, the cells die. Slowing the circulation of extra- and intracellular fluids at the level of the skin and the whole body causes disease. The deforming process in capillaries, which coincides with the aging process of human skin, begins on average at 40–45 years. This phenomenon can be considered as one of the triggers for cosmetic problems, imperfections and skin defects. Disturbances in the microcirculation system underlie such dermatological diseases and aesthetic defects as rosacea, acne, atopic and perioral dermatitis, rosacea, dyschromia, age-related skin changes, hydrolipodystrophy, varicose veins, etc.

Mesotherapy has a pronounced positive effect on capillaropathies, which is greatly enhanced if we work with vascular preparations. The result of such a correction course is an improvement in complexion, increased skin moisture and turgor, relief of the inflammatory process, as well as headaches (especially migraine), radiculopathies, paresthesias, sleep disorders, which will certainly be a pleasant bonus for the client.

Biorevitalization: breathe new life

Biorevitalization as a type of mesotherapy appeared in 2001. The procedure is a method of intradermal injections of HA to restore the physiological state of the dermis. The name literally translates as “natural return to life” (“bio” - natural, natural, “re” - return, “vita” - life).

In biorevitalization, unlike mesotherapy, only one substance is used - hyaluronic acid. Moreover, if in mesotherapy products it is as close as possible to the natural one, which is synthesized by fibroblasts, and its concentration is from 0.5 to 1%, in the case of biorevitalization, not only native, but also partially modified HA is used, the concentration of which can reach 2, 5–3%. The drugs are a viscous elastic gel that is administered intradermally. When producing biorevitalizants, HA undergoes a special treatment, which allows it to remain in the skin for a longer time (up to two weeks) without breaking down into excreted components, creating conditions for the synthesis of collagen in the skin.

The first impression after biorevitalization is always very good: at the site of drug administration, the tissues thicken due to slight swelling, their elasticity increases, and the skin smoothes out literally before our eyes. You should not expect such a quick effect from cocktails used in mesotherapy. The visible result occurs only after 3-4 procedures, which does not always suit the client. By the end of the biorevitalization course, collagen and elastin fibers begin to form, as a result of which the microrelief of the skin improves, the severity of folds decreases, and the face looks noticeably younger. From the start of treatment to visible lifting caused by neocollagenogenesis, an average of 2–3 months passes.

Another significant difference between mesotherapy and biorevitalization is the area of influence. In the first case, due to the coverage of a large area (mesozone), a more pronounced effect is exerted on the skin. Therefore, this procedure is beneficial for older clients, when involutive changes have already begun to occur in the tissues. Biorevitalization involves a clearly targeted effect on smoothing specific wrinkles and lifting a specific area of the face or body. Hydrating biorevitalization programs benefit in cases of prevention, and the advantages of mesotherapy include the ability to use targeted drugs - for example, consisting of structural elements of collagen and inducers of its synthesis for skin rejuvenation. This allows you to realize a more pronounced anti-aging effect or solve other aesthetic problems. As you know, biorevitalization requires a rehabilitation period, since traces of the injected drug (papules) are visible for several days. During mesotherapy, papules dissolve quite quickly, so if you managed to perform the procedure without hematomas, after 30–40 minutes there will be no traces of cosmetic intervention left on the face, which is a positive moment for the client.

Biological agents: persistent and bioactive

Bioremedies are modified HA with bioactive substances sewn onto it - vitamins, amino acids, peptides, vital for skin restoration. Accordingly, the main indication for bioreparation is age-related skin changes.

The presence of numerous free hydroxyl groups makes it possible to attach the required biologically active components to the HA macromolecule, thus changing its spatial configuration. Compared to the native one, HA modified in this way is no longer so easy to destroy by hyaluronidase; accordingly, the residence time of the drug in the dermis increases. At the same time, bioactive substances associated with the polymer macromolecule remain in tissues throughout the entire period of HA biodegradation, maintaining their properties, which is especially important for compounds that are easily oxidized under conditions of conventional storage and sterilization.

All bioremedies, in addition to HA, contain vitamin C, which affects the formation of glycosaminoglycans, stimulates the proliferation of fibroblasts and, consequently, the production of collagen, improves the condition of the skin, effectively combating the primary signs of aging. It is known that ascorbic acid helps reduce the production of metalloproteinases - enzymes that destroy collagen in the dermis.

In addition to vitamin C, we can add a number of amino acids to HA, which will determine the individual properties of each drug.

Thus, the amino acids glycine, proline, lysine and valine, being part of the main proteins of the intercellular matrix of the dermis, are necessary to trigger the synthesis of one’s own collagen and elastin, which is of undoubted interest for patients with fine-wrinkle type of aging.

Sulfur-containing amino acids (cysteine, methionine) and the tripeptide glutathione are powerful antioxidants that act at various stages of the free radical oxidation process, while in the body cysteine and glutathione restore the oxidized form of vitamin C to its original active form. This combination is indicated for clients with problems of rosacea and hyperpigmentation.

L-carnitine helps normalize water-salt balance, tissue respiration, stimulates reparative processes, and has a lipolytic effect, which is important for “tired” and deformed morphotypes.

Summarizing the above, we can conclude that the action of bioremedies is varied, but all of them are capable of restoring the physiological balance of metabolic processes that is disrupted with age, activating synthesis processes. This approach ensures long-term activation of metabolic processes sufficient to restore damage to the intercellular matrix and subsequent preventive protection of the dermis from the effects of unfavorable, aggressive environmental factors. The visual effect appears after the first procedure and continues to increase throughout the course: the relief of surface wrinkles is leveled, the color and texture of the skin and its turgor are improved, sagging disappears, and a pronounced lifting effect appears.

The full version of the article can be read in Les Nouvelles Esthetiques 4 (110)/2018