Mesotherapy in Aesthetic Medicine: clinical evidence, biological rationale and the need for medical regulation
Year: 2026
Type: article
Abstract: Background: Mesotherapy, or local intradermal therapy (LIT), is a minimally invasive technique involving the administration of small volumes of active substances into the dermis, a biologically active interface rich in vascular, neural, and immune components. In parallel with the growing demand for non-surgical aesthetic procedures, the use of mesotherapy has expanded considerably; however, its clinical diffusion has often exceeded the consolidation of robust scientific evidence, resulting in heterogeneous and frequently empirical practices. Methods: This article is conceived as a narrative review and expert position paper, aimed at critically summarizing and contextualizing current knowledge on the biological rationale, clinical applications, and safety profile of mesotherapy in aesthetic medicine. Results: From a biological perspective, experimental and clinical data support the concept of mesodermal modulation, whereby the combined pharmacological, mechanical, and neuroimmune effects of intradermal microinjections lead to prolonged local bioavailability of active substances, modulation of microcirculation, and modeling of the dermal–hypodermal interface. Clinically, these mechanisms provide a rationale for the reported benefits of mesotherapy in selected indications, including microvascular and edematous disorders, dermatologic conditions such as androgenetic alopecia and melasma, and aspects of skin aging, with documented improvements in hydration, elasticity, dermal architecture, and related symptoms. Nevertheless, the strength of evidence varies across indications, and outcomes are influenced by protocol heterogeneity, product selection, and operator expertise. Conclusions: Given its invasive nature and the administration of pharmacologically active substances, this position paper supports the view that mesotherapy should be regarded and regulated as a medical act. Appropriate patient selection, diagnostic evaluation, standardized evidence-based protocols, and the ability to manage potential adverse events justify its performance exclusively within a regulated medical framework by trained physicians.
Source: Aesthetic Medicine
Institution: Azienda Sanitaria Locale Roma 3
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7219857094