19 April 2011

Mesotherapy: cellulite solution?

Considering mesotherapy to get rid of the unsightly dimples on your bottom? Before you book a treatment, read this first.


A number of readers have been asking where they can get mesotherapy treatment to either lose weight and/or reduce cellulite.

I, therefore, decided to do a search on the internet, both globally and in South Africa, to see what this treatment entails, if it is available in South Africa and if it is safe.

The results of my search showed that mesotherapy is available in South Africa, and you should be able to find details by doing a Google search on the SA internet, using 'mesotherapy' as your search term.

What does mesotherapy entail?
According to mesotherapy websites overseas and in SA, this technique was developed in Europe to treat local medical and cosmetic conditions, such as arthritis and pain. The process involves injection of a number of different compounds under the skin into the mesoderm.

More recently, mesotherapy has also been used for the removal of fat and cellulite.

The various compounds that are injected under the skin include: collagenase, hyaluronidase, aminophylline, phosphatidylcholine, deoxycholate, L-carnitine, artichoke extract, melliotis, pentoxifylline and lecithin-based compounds.

According to Rotunda & Kolodney (2006), who did a literature study on the subject of mesotherapy and the use of phosphatidylcholine injections, these two treatments should be regarded as two separate entities.

These authors believe that the name 'mesotherapy' should only be used to describe the injection of compounds to relieve pain and treat vascular disorders (e.g. varicose veins) and not for the treatment of cellulite or removal of fat.

They do conclude that the injection of phosphatidylcholine together with an emulsifier called deoxycholate is "effective in removing small collections of adipose tissue".

But they warn that the use of injections to remove fat and treat cellulite is still in the experimental stages and that a great deal of additional research is required to determine how successful and safe this procedure really is.

What is cellulite?
Dr Avram (2004) of the UCLA Medical Centre in Los Angeles points out that up to 98% of women of all races are affected by cellulite. Unfortunately, there have been few well-controlled scientific studies in this field.

Dr Avram acknowledges that there is "no definitive explanation for its presentation". There are four leading theories that attempt to explain why some women develop cellulite:

  • sexual differences in skin 'architecture' or build-up
  • changes in the connective tissue
  • changes in the vasculature
  • inflammatory factors

Dr Avram states that at present, "there are no truly effective treatments for cellulite".

But the international and South African websites that advertise mesotherapy assure readers that their treatments will remove cellulite.

So, who is right? I am inclined to believe scientific reports rather than advertisements, particularly in view of the rather worrying side effects I unearthed during my searches (see below).

Side effects of mesotherapy
A Pubmed search of the scientific literature showed that as mesotherapy becomes more popular, more and more reports of negative side effects are being published.

In January and February 2005, the Centres for Disease Control and Prevention (CDC) in the USA published a warning of an outbreak of mesotherapy-associated skin reactions.

According to their report, an outbreak of skin reactions occurred in the District of Columbia which did not respond to antibiotic treatment. The patients with these skin reactions had been treated with mesotherapy by 'an unlicensed practitioner' (i.e. someone without a medical qualification).

The CDC urged patients not to accept treatment from anyone who is not a licensed medical practitioner, and not to permit themselves to be injected with substances that have not been approved by the Food and Drug Administration (FDA).

Other negative recently reported side effects linked to mesotherapy include:

  • Systemic lupus erythematosus
  • Soft-tissue infections due to non-tuberculous mycobacteria (pathogens)
  • Abdominal haematoma (bleeding under the skin of the abdomen)
  • Subcutaneous nodules with fat necrosis (formation of nodules under the skin)
  • Pigmentation changes

In view of the above, one can really ask the same question Dr Rivera-Olivero and his coworkers (2006) asked: "What is the price of beauty?"

Precautions when using mesotherapy
Due to all these negative side effects, individuals who intend undergoing mesotherapy to remove fat and cellulite, should take the following precautions:

  • Only allow specially trained physicians to administer these injections
  • Avoid treatment by lay persons who are not medically qualified
  • Determine if the product that is to be injected has been approved for use in humans by the Medical Control Council of SA

Keep in mind that mesotherapy only removes small quantities of fat immediately under the skin and that it will not make a dramatic difference to your total body weight. It is also relatively expensive and the effects are not permanent.

If you have a great deal of weight to lose, you still need to combine a slimming diet and exercise to shed those unwanted kilos. Having a few injections of plant extracts, or chemicals, or vitamins under the skin will not solve the problem.

If you do decide to have mesotherapy treatment, then always remember that there can be negative side effects such as bleeding, infections and skin changes and that you must ensure that the treatment is being supplied by a medical practitioner, who is qualified in performing these procedures. – (Dr Ingrid van Heerden, DietDoc, updated April 2011)

(Avram (2004). Cellulite: a review of its physiology & treatment. J Cosmet Laser Ther, Vol 6(4): 181-5; CDC (2005) Outbreak of mesotherapy-associated skin reactions. MMWR Morb Wkly Rep, Vol 54(44):1127-30; Rivera-Olivero et al (2006). Soft-tissue infections due to non-tuberculous mycobacteria following mesotherapy: What is the price of beauty? Enferm Infecc Microbiol Clin, Vol 24)5):302-6; Rotunda & Kolodney (2006). Mesotherapy & phosphatidylcholine injections. Dermatol Surg, Vol 32(4):465-80)

Read more:
Melt away your fat?
Experts warn against mesotherapy


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