Mesotherapy

This article deals with what the aesthetic procedures offered under the name mesotherapy aim at, and how those aims have been assessed in research. The findings for skin appearance, hair loss and cellulite are examined separately. The identity of the preparation used, the comparison made in the research, the risks and the authorisation framework in Türkiye are assessed together. The aim is not to recommend a mixture or a procedure but to make it possible to assess the different applications offered under the same name. This information does not take the place of a personal examination and treatment decision.

What is mesotherapy?

Is it a product or a route of administration?

Mesotherapy is a technique in which different substances are delivered into the skin through small injections; it is not the name of a single drug or of an unvarying mixture.^1,2 In the Ministry of Health's book on mesotherapy applications, the use that developed for painful conditions and the aesthetic research published later are described separately.² What is assessed here is the aesthetic use, not the treatment of pain.

Research on hair loss makes the breadth of the name concrete. In the review by Gupta and colleagues, the different preparations listed as dutasteride, minoxidil, growth factors or autologous suspension, botulinum toxin A, stem cells, and mesh solutions and multivitamins are gathered into 6 classes of agent.¹ That list is not a recommendation; it shows that contents differing from one another have been studied under the same procedural heading.¹

Answering the question "does mesotherapy work?" by the name of the procedure alone therefore remains incomplete. The substance studied, the area treated and the change measured all have to be known. The result for a hyaluronic acid preparation studied for the skin cannot be carried over to a drug mixture used for hair; the research below assessed different contents and different outcomes.^1,3 For the same reason, an unfavourable result for one preparation does not invalidate all mesotherapy research.

Is it the same thing as PRP and fillers?

What a preparation is and how it is delivered are separate questions. That the hair review gathers autologous suspensions and other agents under the same technical heading does not mean these substances are identical.¹ The PRP article deals separately with the nature of that preparation and with its own evidence. The injection research here does not stand in for PRP; nor are PRP results used as the success of other mixtures.

In skin research with hyaluronic acid, measurements such as appearance, radiance, elasticity and hydration have been made.^3,4 That the name of a substance also appears in the dermal fillers article does not show that this research examined the same product, the same target or the same outcome. The skin results reported here are not a measurement of how much volume will be added to an area or how far tissues will be lifted.^3,4

Which changes are to be expected, and which are not?

Why are skin, hair and cellulite assessed separately?

In skin research, an appearance score given by experts and a skin property measured by a device are not the same outcome.^3,4 In hair research, the number of hairs in a given area, the diameter of the shaft and the proportion of the area covered by hair have been measured separately.⁵ In the cellulite study, a grading of skin appearance was used together with ultrasound measurements.⁶ Presenting all of these as a single "rate of renewal" obscures the change the research actually showed.

The controlled studies in the hair section examined particular groups of women and men with androgenetic alopecia.^5,7 Those results do not mean that every cause of hair loss has been treated. In the same way, the American Academy of Dermatology (AAD) states that cellulite and the amount of fat are not the same thing and that a procedure which reduces fat does not necessarily correct cellulite.⁸ An area becoming smaller and the surface appearance of the skin changing are separate aims.⁸

Regional fat reduction is the subject of non-surgical fat reduction; only the scope and the safety limit are noted here. The United States Food and Drug Administration (FDA), in its information dated 20 December 2023, reports permanent scars, serious infections, skin deformities, cysts and painful knots following unapproved lipolysis injections.⁹ The FDA's communication of 15 September 2026 concerns the use of deoxycholic acid outside the approved submental area; 129 adverse event reports since 2015, blurred or reduced vision with use around the eye, and muscle and nerve injuries were recorded.¹⁰ 129 is a number of reports, not a frequency among those who had the procedure.¹⁰ The same communication states that nodules and masses have also been reported with the approved submental use, that they may not resolve over time and that they may require medical intervention.¹⁰ These warnings should be read with their own substance, area and United States scope; they are not a common risk rate for all mesotherapy mixtures.

What does the evidence on efficacy show?

What have the studies on skin appearance measured?

55 women were included in the efficacy assessment of the randomised, split-face study by Baspeyras and colleagues.³ A preparation containing non-cross-linked hyaluronic acid, glycerol and mannitol was given in one cheek and normal saline in the other; assessments were made 1 and 3 months after the last application.³ The change from baseline and the change relative to the control side were thus examined separately in the same person.³

In the skin radiance scored by an expert panel, a significant between-group difference in favour of the preparation was reported at 3 months, with p = 0.012.³ In the E1 measurement related to elasticity, by contrast, the between-group difference at 3 months was not significant, with p = 0.0634.³ Dermis thickness increased at 1 month on both the preparation side and the saline side; no significant between-group difference was shown for thickness.³ Nor was a between-group difference found in the assessments of wrinkles, firmness and evenness.³ Participants' own assessments, on the other hand, reported a difference in favour of the preparation. The proportion saying they perceived slight to marked improvement was 60 per cent against 27.3 per cent at 1 month, and 51 per cent against 20 per cent at 3 months.³

This study shows the importance of the question "improvement compared with what?". The preparation side changing relative to its own baseline does not mean it passed the control on every measure.³ The favourable radiance finding should be preserved; but that finding should not be put in place of the wrinkle or firmness results, where no difference was found in the same study.

In the study by El-Domyati and colleagues of 6 women, which had no separate control arm, a mixture of multivitamins and non-cross-linked hyaluronic acid was examined.¹¹ At the end of treatment and 3 months after it, no significant change was found in the clinical assessment or in the histological measurements relating to collagen and elastin.¹¹ This small, uncontrolled study does not prove that all preparations are ineffective; it gives the result only for the preparation and measurements examined.

456 people were enrolled in the larger study by Yang and colleagues and 439 completed it; of those who completed, 287 were in the preparation group and 152 in the control group.⁴ A preparation containing sodium hyaluronate and amino acids was compared with a control group that received no procedure at all.⁴ The assessor was blinded; the control group, however, received neither a needle nor a placebo.⁴ It should therefore not be read as a placebo comparison that equalises the participant's expectation of a procedure.

The assessment made with the Global Aesthetic Improvement Scale (GAIS) 1 month after the last application is below.⁴ GAIS divides the change in appearance into categories; it does not measure what percentage of the face has been rejuvenated.⁴

GAIS assessment	Preparation group, 287 people	No-procedure control, 152 people
Very much improved	16 people, 5.57 per cent	0 people, 0 per cent
Much improved	118 people, 41.11 per cent	1 person, 0.66 per cent
Improved	146 people, 50.87 per cent	5 people, 3.29 per cent
No change	5 people, 1.74 per cent	137 people, 90.13 per cent
Worse	2 people, 0.70 per cent	9 people, 5.92 per cent

The table shows all the GAIS categories of the same study.⁴ The proportion meeting any threshold of improvement was reported as 97.56 per cent in the preparation group and 3.95 per cent in the control group.⁴ The difference between the rates is 93.61 percentage points; the 95 per cent confidence interval of that difference is 90.04 to 97.19 percentage points.⁴ The interval belongs to the difference between the groups, not to the response rate of either group on its own.⁴

50.87 per cent of the preparation group falls in the "improved" category alone; the total response rate does not say that all participants experienced much or very much improvement.⁴ That the result belongs to one preparation, to this scale and to a comparison with no procedure should also stay alongside the figures. That another mixture would produce the same rate, or that this result would be retained for a long time, cannot be derived from this comparison.

Which preparations have been studied in hair loss?

In the systematic review by Gupta and colleagues, 27 articles out of 416 records were taken into the assessment.¹ Significant favourable results for hair growth were reported in some studies; against this, it was stated that there is no standardised regimen and that larger controlled studies are needed.¹ This is not a result giving a single success rate for all hair mesotherapy.

In the single-blind randomised study by Wang and colleagues, 40 women with androgenetic alopecia were divided into groups of 20.⁵ An injection containing minoxidil was compared with topical use of the same active substance at a different concentration.⁵ Treatment lasted 16 weeks and the final follow-up visit was 4 weeks after it ended.⁵ It is therefore not an experiment in which only the route of administration was changed and every other condition held the same.

The mean increase in hair density was reported as 8.70 ± 6.17 hairs/cm² in the injection group and 4.50 ± 2.98 hairs/cm² in the topical group; the ± values are standard deviations.⁵ After correction for multiple comparisons the difference in density remained significant, with p = 0.041; a significant difference was also found in the change in coverage, with a corrected p of 0.036.⁵ No significant between-group difference was shown in the other 7 trichoscopic measures; these are hair diameter, hairs per follicular unit, the proportion of single-hair units, and the vellus, intermediate, terminal and terminal-to-vellus ratios.⁵ The physicians' assessment reported greater improvement in the injection group, while no significant difference was found in the participants' own assessments.⁵

In this study, significant between-group differences were shown on some measures, but not on every measure.⁵ The mean increase in density is not the amount of hair a single person will gain; it cannot be used as an estimate for other diagnoses of hair loss or for other mixtures.

In the comparison by Gajjar and colleagues of 49 men, 25 received a multi-component preparation together with microneedling and 24 topical minoxidil, and the assessment ran for 4 months.⁷ At the final assessments, no overall superiority was shown in the dermoscopic, hair-measurement or subjective outcomes.⁷ Because microneedling accompanied the treatment, the result obtained cannot be separated out as the independent effect of the injection.⁷ Nor does finding no difference mean that the equivalence of the methods has been proven.

How strong is the evidence for cellulite?

The AAD places mesotherapy among the applications it does not recommend for cellulite.⁸ The organisation states that, because practitioners use different mixtures, there is no way to determine which ingredient, if any, is effective, and that few studies show benefit.⁸ This view should not be confused with the particular research result for a single preparation.

In the study by Mlosek and Malinowska, 84 women were examined in groups receiving a ready-made cellulite injection product, a body wrap and mechanical tissue mobilisation; the groups had 24, 29 and 31 people respectively.⁶ Although the abstract uses the word randomised, the methods section describes the allocation as quasi-randomised.⁶ Measurements were made 14 to 18 days after the end of treatment.⁶

Favourable changes from baseline were reported in some ultrasound measurements in the groups, and no significant between-group difference was shown after treatment.⁶ The reduction in dermis thickness was significant in the body wrap and mechanical tissue mobilisation groups but not in the injection group, where the p value was 0.5.⁶ The absence of an untreated control, the short follow-up and the fact that the full composition of the injected product is not given in the methods section limit generalisation.⁶ This research shows that a favourable short-term finding exists; it does not give the conclusion that all cellulite mixtures are effective or that the AAD's assessment no longer holds.

How are authorisation and the nature of the product assessed in Türkiye?

How do the general facility conditions combine with a GETAT certificate?

How health services for aesthetic and cosmetic purposes are to be provided in private outpatient diagnosis and treatment facilities is governed by the Regulation on Private Health Facilities Providing Outpatient Diagnosis and Treatment, dated 19 April 2025.¹²

The provision in force requires three conditions together. Health services for aesthetic or cosmetic purposes may be provided within a medical centre, a polyclinic or a doctor's practice; within the competences physicians have acquired through their training curriculum or through a certificate; within the medical procedures permitted at the facility where they work; and provided that the physical space and minimum medical equipment defined for a polyclinic room are in place.¹²

The certificate referred to in the regulation is one registered under Ministry legislation.¹²

The physician's competence and the facility's authorisation are separate things and both are required.¹² A diploma alone, or any course certificate alone, does not show that all of these conditions are met. Nor is a training centre's authorisation to provide training the same thing as a physician's authorisation to carry out the procedure.^12,13

This provision covers private outpatient diagnosis and treatment facilities. A complete list of authorisation by profession and title, for every type of institution, cannot be derived from this text.¹²

For mesotherapy there is a separate route of authorisation added to these general conditions. The Ministry of Health's 2022 book explains that mesotherapy is the 10th application in the Annex-3 list of the Regulation on Traditional and Complementary Medicine Practices dated 27 October 2014.² The book states that the application may be carried out by physicians who have received certified training in mesotherapy, and by dentists who have received that training, in the field of dentistry only.² Under the Standard for Certified Training in Mesotherapy, registration of the certificate by the Ministry is required.²

That mesotherapy does not appear in the curriculum of the Standard for the Certified Training Programme in Aesthetic and Cosmetic Applications dated 3 September 2025 does not mean there is a gap in the regulation here; there is a GETAT certification route specific to mesotherapy.^2,13 The general facility conditions do not take the place of that certificate, and the certificate does not remove the facility's conditions of permission.^2,12 This explanation rests on the transmission of the legislation in the Ministry's own book, not on a direct quotation from Annex-3.²

What information about the substance to be given is needed?

Authorisation to carry out the procedure and the suitability of the substance used for a particular purpose have to be assessed separately. That the hair review treats different classes of agent together shows that the name "mesotherapy" alone does not explain the content.¹ For a reader, understanding whether the substance in the research and the preparation being spoken of are the same is where assessing a study result begins.

The concepts of a licence, the Summary of Product Characteristics and the Drug Tracking System are explained separately in the botulinum toxin article. The safety events specific to that substance are not data for the mixtures here. The Ministry's book states that the use of sterile, single-use mesotherapy needles, syringes and gloves during the application is mandatory.² An efficacy study for a preparation should not be read as taking the place of those conditions.

What are the risks and unwanted effects?

How are local effects distinguished from infection?

Of the 57 people included in the safety assessment of the Baspeyras study, 50, that is 87.7 per cent, had one or more unwanted effects after injection.³ The effects reported are haematoma, oedema, papule, erythema and transient inflammatory reactions; the most common was haematoma, recorded in 35.7 per cent on the cheek given hyaluronic acid and in 20.5 per cent on the cheek given saline.³ Four people developed severe haematoma on the hyaluronic acid side.³

That high rate does not mean a lasting problem. In the same study all the expected unwanted effects resolved in a mean of 5.9 days, and local tolerance was found to be good or excellent in 85 to 100 per cent of the assessments.³ Unwanted effects were also recorded on the cheek given saline.³ This comparison does not separately measure the contributions of the needle and the substances injected.³

The effects the AAD lists for cellulite mesotherapy are redness and swelling, tender lumps beneath the skin, infection, allergic skin reaction and skin changes.⁸ This list shows which risks have been reported; it does not give the same probability for all preparations.

In the 300-person safety group of the Yang study, product-related adverse reactions were reported in 5 people, a rate of 1.67 per cent, and no serious event occurred.⁴ The same study treats injection-site pain, redness and swelling separately from that rate, describing them as mostly mild and transient and as consistent with the needle entering the tissue.⁴ The 1.67 per cent is therefore not the rate of all effects after injection, and it cannot be set against Baspeyras's 87.7 per cent record of events to rank safety.^3,4 The safety denominator is 300; it is not the same denominator as the 287-person preparation group in the efficacy assessment.⁴ The breakdown in Table 7 is below.⁴

Reaction reported	Number of people and severity	Approach and outcome as reported in the table
Hyperpigmentation, darkening of colour	4 people; 3 mild, 1 moderate	No treatment in 3, local intervention in 1; resolution in all
Allergic reaction	1 person; moderate	Treated with antihistamines; recovery without sequelae

The narrative of the article says that the events other than the allergic reaction passed without intervention, while the table records one local intervention; the detailed breakdown in the table has been taken as the basis here.⁴ The low reported rate and the absence of serious events are a favourable safety finding for the preparation examined.⁴ That rate cannot be carried over to different contents, and it does not guarantee that a rare event will never occur. The article reports that the study was funded by a biotechnology company and that one of the authors works for that company.⁴ This information does not in itself invalidate the results; it is read together with the need for confirmation by independent research.

In the Wang study, no serious adverse events were reported in either group.⁵ These local effects and the infection cases below are not the same outcome. Calculating a common complication rate by combining figures from different preparations and samples would not be appropriate.

Why do delayed nodules and abscesses matter?

The review by Singsing and colleagues assessed 30 articles reporting 423 people who developed a non-tuberculous mycobacterial infection after mesotherapy.¹⁴ These people are not a sample of everyone who has had mesotherapy but the group of infection reports; the review's inclusion criteria cover aesthetic, lipolysis and pain applications.¹⁴ The frequency of infection in aesthetic mesotherapy therefore cannot be derived from that figure.

In the 135 people whose time of onset was reported, symptoms appeared between 1 day and 3 months after injection, with a mean of 32.5 days.¹⁴ The lesions were generally reported over the injection sites, as nodules or abscesses.¹⁴ That mean is not a waiting period. It matters that a hardness, abscess or discharge starting late or persisting in the injected area is reported in an assessment together with the history of the procedure.¹⁴

Most of the infections in the review resolved with treatment; the treatment period, however, was long. At least 95 per cent of the recorded antibiotic courses lasted between 3 and 8 months, and of the 280 people for whom treatment information was available, 23.2 per cent had surgical drainage in addition to antibiotics.¹⁴ Some people required more than one course of treatment and were left with scarring.¹⁴ The finding of resolution and this burden should be assessed together. A person having no problem in the first days does not exclude the possibility of the late onset shown in the review.¹⁴ On the other hand, describing these cases in detail does not mean that such a problem is expected after every injection.

How is the duration of the result assessed?

Is a follow-up period a matter of permanence or a repeat schedule?

In the skin research there are assessments 1 and 3 months after the last application, in the hair studies a follow-up of several months, and in the cellulite study a measurement 14 to 18 days after the end of treatment.^3,4,6,7 These are research time points set for different contents and different outcomes. The follow-up period of one cannot be used as the duration of effect of another.

A measurement being favourable at the final visit does not show that the effect will end that day; nor does it explain by itself what will happen after the follow-up is complete. Without knowing which measure was assessed at which time in the research, a sentence saying "the effect lasts this long" remains incomplete. The short follow-up of the cellulite study in particular does not support a claim of long-term persistence.⁶

The need for repeat treatment is also a question separate from the initial research result. The Gupta review's warning about the lack of a standardised regimen does not allow a common repeat schedule to be established for all hair mesotherapy.¹ The follow-up periods of the research are given in this article; no individual interval of application or obligation to continue is derived from them.

What matters in an assessment?

Why do the goal and the preparation used have to be known together?

Rather than leaving a wish for change as a broad expression such as "renewing the skin", separating out which property is expected to change makes comparison with the research easier. A change in a radiance score, a wrinkle measurement and hair density differ from one another; the sources assessed these outcomes separately.^3,5 A favourable finding in one does not mean the other has improved as well.

The identity of the preparation, previous applications and a history of reactions also occupy a separate place in an assessment. In the Baspeyras study, a history of allergy to the ingredients and certain conditions of the facial area were among the exclusion criteria.³ What that means is that the research assessed a selected group; it would not be right to treat the same list as a complete rule of suitability valid for every substance.

In situations such as pregnancy and breastfeeding, too, the data for one mixture should not be carried over to another. Some of the controlled studies dealt with here used pregnancy and breastfeeding as exclusion criteria.^3,5 That exclusion is not proof that all preparations cause harm; nor does it provide any assurance of safety for these groups. Without the content of the mixture being explained, a statement such as "it is suitable for everyone" goes beyond the scope of the research.

How should marketing language be read?

What do "vitamin", "cocktail" and "clinically proven" not prove?

The words "vitamin" or "cocktail" give limited information about a content; on their own they do not describe a measured outcome. That no significant clinical change was found in the study of multivitamins and hyaluronic acid makes concrete the point that benefit cannot be inferred from the name of a content alone.¹¹ Against this, a favourable controlled finding having been reported with another preparation should not be disregarded either.⁴ An assessment should rest on the preparation studied, not on a single label, whether optimistic or dismissive.

When the phrase "clinically proven" is encountered, which outcome and which comparison is meant is what determines its value. In the Baspeyras study, differences favouring the preparation were reported for radiance and participants' own assessments; no between-group difference was found in the assessments of wrinkles, firmness and evenness.³ Presenting that research as showing that every sign of ageing improved widens the limit of the source. In the same way, an appearance response obtained against a no-procedure control should not be described as superiority over a placebo injection.⁴

Research in which a preparation is used together with another method may also not show its effect on its own. The microneedling in the Gajjar study is the example of that distinction.⁷ Reporting the heading as mesotherapy alone makes the share of the accompanying procedure in the result invisible. After which interventions a favourable or unfavourable result was measured has to remain clear.

Why are the route of administration, the licence and the authorisation separate?

The name of a procedure does not explain the practitioner's documentation. The certification route the Ministry reports for mesotherapy is a condition to be verified separately from the general naming of an aesthetic procedure.² That the conditions for the physician and the facility are required together shows that it cannot be concluded from a training document alone that all the conditions have been met.¹²

In the same way, a favourable result for the preparation used in one study does not show the suitability of every mixture offered under the same name. The AAD's warning that the effective ingredient cannot be determined because different mixtures are used is important for that reason.⁸ The existence of research, the disclosure of the content and the verification of authorisation answer different questions; one does not stand in for another.

How should the figures in this article be read?

The number of people in a study, the number analysed and the number in the safety group may not be the same. In the Yang study, 456 enrolled, 439 completing, a 287-person efficacy group for the preparation and a 300-person safety denominator were reported separately.⁴ If these denominators are used in place of one another, a correct figure carries a mistaken meaning.

The percentage in the GAIS table is the share of people falling into a particular appearance category; it is not the size of the change in per cent.⁴ The hairs/cm² in the hair study describes the mean change in a given area; the standard deviation beside it shows the spread between people.⁵ A confidence interval, a standard deviation and a p value are not the same information. Finding a significant difference does not mean the same result will occur in everyone, and finding no difference does not mean the two methods are equivalent.

Finally, the infection review gives information about the course in people who developed the problem; it does not measure the risk of everyone who has the procedure.¹⁴ The figures of an efficacy study and of a case review cannot be added together. The assessment here does not produce a single "mesotherapy success rate"; it makes visible in which preparation, on which measure and within which period a finding was made, and where that finding stands.

References

1. Gupta AK, Polla Ravi S, Wang T, Talukder M, Starace M, Piraccini BM. Systematic review of mesotherapy: a novel avenue for the treatment of hair loss. J Dermatolog Treat. 2023;34(1):2245084. doi:10.1080/09546634.2023.2245084. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹

2. Republic of Türkiye Ministry of Health, Directorate General of Health Services, Department of Traditional, Complementary and Functional Medicine Practices. Mesotherapy Applications. Ankara; 2022. ISBN 978-975-590-848-9. Legislation section, p. 9. Ministry publication. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰

3. Baspeyras M, Rouvrais C, Liégard L, et al. Clinical and biometrological efficacy of a hyaluronic acid-based mesotherapy product: a randomised controlled study. Arch Dermatol Res. 2013;305(8):673-682. doi:10.1007/s00403-013-1360-7. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰ ↩²¹ ↩²² ↩²³ ↩²⁴ ↩²⁵

4. Yang R, Zhang Y, Zhao H, et al. Efficacy and Safety of a Novel Sodium Hyaluronate Composite Solution via Mesotherapy for Facial Rejuvenation: A Multicenter Randomized Controlled Study. Plast Reconstr Surg Glob Open. 2026;14(6):e7853. doi:10.1097/GOX.0000000000007853. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰ ↩²¹ ↩²² ↩²³ ↩²⁴ ↩²⁵ ↩²⁶

5. Wang X, Weng W, Yan Z, Li J, Song BB, Zhu W. Efficacy and Safety of Mesotherapy With 0.5% Minoxidil Versus Topical 2% Minoxidil for Female Androgenetic Alopecia: A Randomized Controlled Trial. Dermatol Ther. 2026;2026(1):2938873. doi:10.1155/dth/2938873. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴

6. Mlosek RK, Malinowska SP. Using High Frequency Ultrasound to Assess the Efficacy of Anti-Cellulite Treatments. Clin Cosmet Investig Dermatol. 2025;18:2869-2885. doi:10.2147/CCID.S550627. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹

7. Gajjar PC, Mehta HH, Barvaliya M, Sonagra B. Comparative Study between Mesotherapy and Topical 5% Minoxidil by Dermoscopic Evaluation for Androgenic Alopecia in Male: A Randomized Controlled Trial. Int J Trichology. 2019;11(2):58-67. doi:10.4103/ijt.ijt_89_18. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

8. American Academy of Dermatology. Cellulite treatments: What really works? Organisation page. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

9. U.S. Food and Drug Administration. Using Fat-Dissolving Injections That Are Not FDA Approved Can Be Harmful. 20 December 2023. FDA page. ↩

10. U.S. Food and Drug Administration. Labelling warning on adverse reactions associated with the unapproved use of deoxycholic acid injection [title given by subject, without the brand name]. FDA Drug Safety Communication. 15 September 2026. Official communication. ↩ ↩² ↩³

11. El-Domyati M, El-Ammawi TS, Moawad O, et al. Efficacy of mesotherapy in facial rejuvenation: a histological and immunohistochemical evaluation. Int J Dermatol. 2012;51(8):913-919. doi:10.1111/j.1365-4632.2011.05184.x. ↩ ↩² ↩³

12. Republic of Türkiye Ministry of Health. Regulation on Private Health Facilities Providing Outpatient Diagnosis and Treatment. 19 April 2025. Ministry text. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸

13. Republic of Türkiye Ministry of Health. Standard for the Certified Training Programme in Aesthetic and Cosmetic Applications. 3 September 2025. Official standard. ↩ ↩²

14. Singsing ME, Duncan SG, Vachon MJ, Goff HW. Clinical features of mesotherapy-associated non-tuberculous mycobacterial infections: A systematic review. Int J Womens Dermatol. 2022;8(4):e059. doi:10.1097/JW9.0000000000000059. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹