Mesotherapy vs Microneedling: What Is the Difference and Can They Be Combined?

By Andrew Hansford, skin educator and trainer

Are we confused? Do we think mesotherapy and microneedling are the same thing? Can they be done together? Is "meso needling" even a thing?

Mesotherapy and needling are stand alone treatments. Each is individual in its approach and effective in its own right for its chosen outcomes. But there is a grey area, a confusion, a crossover that often has little to do with either treatment. Let me explain.

What is mesotherapy?

Mesotherapy was developed by the French doctor Michel Pistor in the 1950s. It involves placing tiny amounts of active ingredients directly into the skin, exactly where they are needed. I sometimes describe these ingredients as construction materials, or baby food for the skin.

Recent histological, biochemical and biomolecular research has broadened our understanding of how skin cells function as we age, particularly how molecules are transported and how cells communicate. In that context, mesotherapy is pure skin health, maintenance and support. It supports our internal matrix by putting the product in exactly the right place.

Mesotherapy doesn't follow the skin type protocols you see from product companies, such as oily, T zone, dry or sensitive, because it aims to restore the skin at a cellular level. When skin is functioning correctly, many of those concerns settle on their own.

Why placement matters

The stratum corneum is designed to keep things out. Dermatology researchers describe a "500 Dalton rule": molecules larger than about 500 Daltons struggle to pass through healthy skin at all. Many of the powerful actives needed for regeneration are much larger than that, so for them to work, they need to be placed in the skin, alongside proven topical actives such as vitamin A applied on top. The depth of application is the most important part of the procedure.

Once in place, the ingredients help kick start regeneration at a cellular level by working with the epidermal growth factors that communicate with the deeper layers. This allows cells with the right receptors to take the ingredient in so it can carry on its work in regeneration, maintenance and communication.

The whispering wall

The key player in that communication is the cytokine. Cytokines are signalling proteins secreted by cells in the body and skin to command a specific response. They are biological messengers, or conductors, controlling how our skin looks, behaves, heals and repairs after an injury, whether that injury comes from an in clinic treatment or an environmental factor like the sun. So we need to keep them happy, communicating well and not overly stressed by inflammatory procedures.

The right injectable product keeps our matrix and its communication pathways as happy as possible. I think of it like a whispering wall. In the Whispering Gallery at St Paul's Cathedral, if one person whispers into the wall, the sound travels all the way around the gallery. But if someone speaks while it is travelling, the message is lost. Or think of the game where a row of people whisper a message from ear to ear, and by the end of the line it has completely changed.

Mesotherapy aims to keep those messaging pathways clear and keep the matrix fed with all the ingredients it needs.

The research base continues to grow. Reviews have also called for more high quality, well designed trials, so choosing registered products, proper training and evidence based protocols is essential for safe, effective results.

What is microneedling?

Needling is arguably the single best anti ageing treatment, and it has medical roots. It grew out of techniques such as subcision, described by dermatologists in the 1990s for depressed scars, and collagen induction therapy, developed by plastic surgeons around the same time.

In simple terms: create a wound and collagen is produced. Simple, right? No, it isn't! Good results depend on all of the following:

• The epidermis must not be compromised, as it is with aggressive use of rollers
• The target depth for each protocol must be reached
• The time between treatments must be maintained
• Topical products are mostly unnecessary
• Not all devices are created equal

Needling was the first protocol I trained people in, because I loved the idea of treating difficult concerns like stretch marks and scars. That is where I originally learned the most.

It is a clinical treatment and, in my humble opinion, it has been cheapened by all the "options" and combination methods attached to it.

To get the best results, we need to understand the incredibly complicated wound healing response, and we don't want to interrupt it by flooding it with topicals that are not registered for injection and can disrupt the healing cascade, leading to problems down the road.

Needling is regenerative, which means that if a treatment is too aggressive, the negative results won't be seen for a few months. That is exactly what changed the protocols to shorter time frames and shallower depths, relying on the growth factors we naturally release when wounded to follow the path they would take naturally. The time frame for rejuvenation depends on the wound depth, and it doesn't have to mean blood, trauma and downtime. We also don't want the skin to go into an inflammatory response unless it is needed. Our post on why home microneedling can damage your skin explains more.

So, can they be done together?

Both treatments are amazing, and I stand by them being stand alone.

The one crossover is that most needling devices need a glide. For that, use a product that is CE marked for injection, whether that is a hyaluronic acid or a mesotherapy cocktail. It supports the superficial tissue and interacts with the growth factors without compromising the wound response.

As far as I am concerned, these are the two go to treatments, because they are not age dependent and they span the whole spectrum of protocols. Find out more about microneedling and mesotherapy in our treatment guides, or search the directory for a qualified practitioner near you.