Department of Dermatology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain.
Dermatol Ther. 2022 Feb;35(2):e15247. doi: 10.1111/dth.15247. Epub 2021 Dec 13.
Androgenetic alopecia (AGA) is the most common form of non-cicatricial alopecia in both genders. Currently approved drugs for the treatment of AGA include topical minoxidil in women and topical minoxidil and oral finasteride in men. Other routes of administration of approved drugs have been proposed to enhance therapeutic results for AGA, including intradermal injections, known as mesotherapy. Mesotherapy-or intradermotherapy-is a non-surgical procedure, consisting of multiple intradermal injections of pharmacological substances diluted in small doses. Although minimally invasive, mesotherapy may be related to mild side effects like burning, erythema and headaches, as a few reports indicate. Among the most serious adverse events, subcutaneous necrosis, scalp abscesses, and angioedema have been described. This multicenter retrospective, descriptive study aims to report 14 cases of frontal edema resulting from mesotherapy for AGA treatment. In our patients, the edema mostly arose in the first two sessions and lasted between 1 and 4 days, with a favorable outcome after a local cold compress. In all our cases of edema, lidocaine was the anesthetic used. Minoxidil and dutasteride might also play a role as causative agents. To the best of our knowledge, this is the largest case series focused on frontal edema after mesotherapy for AGA and gives clinicians helpful information for when performing this technique. Dermatologists should already consider and be conscious of this possible mesotherapy side effect, as it can be remarkably disruptive to affected patients.
男性型脱发（AGA）是两性中最常见的非瘢痕性脱发形式。目前批准用于治疗 AGA 的药物包括女性外用米诺地尔和男性外用米诺地尔和口服非那雄胺。为了提高 AGA 的治疗效果，已经提出了其他批准药物的给药途径，包括皮内注射，称为中胚层疗法。中胚层疗法或皮内疗法是非手术程序，由多次皮内注射小剂量稀释的药理物质组成。尽管微创，但中胚层疗法可能与轻微的副作用有关，如灼热、红斑和头痛，正如少数报告所表明的那样。在最严重的不良事件中，已描述了皮下坏死、头皮脓肿和血管性水肿。这项多中心回顾性描述性研究旨在报告 14 例因 AGA 治疗的中胚层疗法引起的额部水肿病例。在我们的患者中，水肿主要在前两次治疗中出现，持续 1 至 4 天，局部冷敷后结果良好。在我们所有的水肿病例中，都使用了利多卡因作为麻醉剂。米诺地尔和度他雄胺也可能作为致病剂发挥作用。据我们所知，这是关于 AGA 中胚层疗法后额部水肿的最大病例系列，为临床医生进行该技术提供了有用的信息。皮肤科医生应该已经考虑到并意识到这种可能的中胚层疗法的副作用，因为它会对受影响的患者造成明显的干扰。
