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Criticism

Criticism

Mesotherapy treatments have been performed throughout Europe, South America, and more recently the United States for over fifty years. However physicians have expressed concern over the efficacy of mesotherapy, arguing that the treatment hasn't been studied enough to make a determination. The primary issue is that mesotherapy for the treatment of cosmetic conditions hasn't been the subject of gold standard clinical trials; however the procedure has been studied for the pain relief of other ailments, such as tendonitis, tendon calcification, dental procedures, cancer, cervicobrachialgia, arthritis, lymphedema, and venous stasis.[3] Further, there have been case series and numerous medical papers on the mesotherapy as a cosmetic treatment, as well as studies that employ the ingredients used in mesotherapy.[4][5]

The other side of the debate is expressed by Rod Rohrich, M.D., Chairman, Dept. of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas: "There is simply no data, no science and no information, to my knowledge, that mesotherapy works." The American Society of Plastic Surgeons issued a position statement not endorsing mesotherapy, but this non-endorsement is the subject of some controversy. Since mesotherapy isn't a surgical treatment but, rather, a non-invasive alternative to plastic surgery, the treatment competes with plastic surgery for the same patients.

The FDA cannot control the use of practitioners injecting various mixtures into patient's bodies because this practice falls under the jurisdiction of state medical boards. This is the case because the mesotherapy is considered a "procedure" by state medical boards. The FDA, on the other hand, is mandated to approve foods, dietary supplements, drugs, vaccines, biological medical products, blood products, medical devices, radiation-emitting devices, veterinary products and cosmetics.

Dr. Robin Ashinoff, speaking for the American Academy of Dermatology, says "A simple injection is giving people false hope. Everybody's looking for a quick fix. But there is no quick fix for fat or fat deposits or for cellulite." The American Society for Dermatologic Surgery informed its members in February 2005 that "further study is warranted before this technique can be endorsed."

Many dermatologists and plastic surgeons are alarmed about the growing profile of mesotherapy. "No one says exactly what they put into the (syringe)," says Naomi Lawrence, a derma-surgeon at the University of Medicine and Dentistry of New Jersey. "One drug they often use, phosphatidylcholine, is unpredictable and causes extreme inflammation and swelling where injected. It is not a benign drug." USAToday 8/4/2004.

It is currently banned in a number of South American countries. Even Brazil, which is less strict than the USA in drug approvals, has banned the drug for these purposes. USAToday 8/4/2004.

In Australia, an alternative therapy salon is being investigated by the Health Department after several clients developed skin abscesses on the calves, buttocks, thighs, abdomen, shoulders, face and neck from the treatment, with one patient also developing a mycobacterial infection

History

History

Dr. Michel Pistor (1924–2003) performed clinical research and founded the field of mesotherapy. Multi-national research in intradermal therapy culminated with Pistor's work from 1948 to 1952 in human mesotherapy treatments. The French press coined the term Mesotherapy in 1958. The French Academy of Medicine recognized Mesotherapy as a Specialty of Medicine in 1987. Popular throughout European countries and South America, mesotherapy is practiced by approximately 18,000 physicians worldwide

Mesotherapy

Mesotherapy


Mesotherapy (from Greek mesos, "middle", and therapy from Greek therapeia, "to treat medically") is a non-surgical cosmetic medicine treatment. Mesotherapy employs multiple injections of pharmaceutical and homeopathic medications, plant extracts, vitamins, and other ingredients into the subcutaneous fat. Mesotherapy injections allegedly target adipose fat cells, apparently by inducing lipolysis, rupture and cell death among adipocytes.[1]

Contents


Usage

There are published studies on the clinical treatments and effects of these medications and numerous cocktails of combined chemical compounds on the body have been reported in Europe and South America for several years. There is no conclusive research proof that these chemical compounds work to target adipose (fat cells) specifically. Cell lysis, resulting from the detergent action of deoxycholic, may account for any clinical effect.[2]

Substances used include:

Safety

Safety

Because cosmetics are loosely regulated by the FDA, consideration for the ingredients, age, and usage of the mascara is advisable. A substance is considered a cosmetic if it is used in conjunction with the body in a manner that does not alter the structure of the body or its functions. This leaves a great deal of freedom for the beauty industry in the formulation of cosmetics. Of course, some chemicals are explicitly forbidden from inclusion in a cosmetic. These include biothional, choloroform, halogenated salicylanilides, hexachlorophene, methylene chloride, vinyl chloride and mercury compounds. As an exception, mercury compounds can be used as a preservative in eye make-up and so is occasionally found in mascara [24].

There is some concern for a select few individual ingredients found in mascara since they have been found to cause cancer in mice, and others are known to be highly toxic to the human body or volatile. Despite these disconcerting facts, they exist in minute quantities in mascara, and their presence has not been positively linked to negatively affect health [25].

Proper use of mascara includes disposal of tube and brush after four to six months. Mascara should also be disposed of if found to smell different, strange, or especially pungent. It is unlikely and unusual, but mascara does have the capability to grow bacteria [26]. Because of this and the nature of its usage, people using mascara have a slight risk of eye infection or conjunctivitis, but this is rare [27].

It is more common to develop a stye, or commoner still, swollen eyelids [28]. Stys and swollen eyelids are better classified as allergic reactions. The allergic reactions can be stimulated by any of the components of mascara but is usually attributed to methylparaben, aluminum powder, ceteareth-20, butylparaben, or benzyl alcohol

Manufacture

Manufacture

Which ingredients are chosen also relies on how the mascara is manufactured. Today, there are two main methods of production. The first is referred to as anhydrous. In this method all waxes, oils, and pigments are mixed, heated, and agitated simultaneously in formulated ratios. The result is a semi-solid substance that is ready to be placed in tubes, packaged, shipped and sold. The other method used is termed emulsion. The emulsion method also results in a semi-solid substance, but its procedure greatly differs. In the emulsion method, water and thickeners are first combined. Separately, waxes and emulsifiers are mixed and heated. Pigment is then added individually to both mixtures. Finally all is combined in a homogenizer, which acts as a high-speed agitator in order to thoroughly mix the oils, water, waxes, and emulsifiers—ingredients that naturally repulse each other

Ingredients

Ingredients

The increased demand for mascara led to the development of the many formulas seen in the current market. Despite the many variations, all formulas contain the same basic elements: pigmentation, oils, and waxes.

The pigmentation for black mascara is similar to the pigmentation used by the Egyptians and Victorian women. Carbon black, instead of soot or ash, is used. Tar and coal derivatives are strictly prohibited by the FDA. Brown mascaras typically color by use of iron oxides though the specific compounds are unique to each brand. In some mascaras, an additional pigment of ultramarine blue is added [3].

There is a great deal more leeway and variety among the oils used. Different mineral oils, linseed oil, castor oil, eucalyptus oil, lanolin, and oil of turpentine can be found most frequently among the many formulas. Sesame oil is also commonly used [3].

Waxes usually found in mascara are paraffin, carnauba wax, and beeswax [3].

The desired effects of the mascara account for most variations of ingredients. The most basic effect considered is whether the mascara will be water-resistant or not. Water-resistant mascaras have basis in substances that rebuff water, like dodecane. Non water-resistant mascaras have base ingredients that are water-soluble [22]. Mascaras designed to lengthen or curl the eyelashes often contain nylon or rayon microfibers [23]. Additionally, ceresin, gum tragacanth, and methyl cellulose are regular ingredients added to act as stiffeners

History

History

Aesthetic adornment is a cultural universal and mascara can be documented in ancient Egypt. Records from around 4000 BC refer to a substance called kohl that was used to darken eyelashes, eyes, and eyebrows [3]. Kohl was used to mask the eyes, warding off evil spirits and protecting the soul, by both men and women. Often composed of galena, malachite, and charcoal or soot, crocodile stool, honey, and water was added to keep the kohl from running [4]. Through Egypt’s influence, kohl usage persisted in the subsequent Babylonian, Greek and Roman empires. Following the fall of the Roman Empire, kohl fell into disuse on the European continent, where it had been considered solely a cosmetic; conversely, it continued to be widely-used in the Middle East for religious purposes [3].

Make-up was considered unsightly and uncouth in Western culture up until the Victorian era. During the Victorian era, social opinion shifted radically towards the promotion of cosmetics, and women were known to spend a majority of their day occupied with beauty regimens. Great efforts were made to create the illusion of long, dark eyelashes [5]. Attempting this, Victorian women made a type of mascara in their own homes [6]. They would heat a mixture of ash or lampblack and elderberry juice on a plate and apply the heated mixture to their eyelashes [7].

The product that people would recognize as mascara today did not develop until the nineteenth century. A chemist named Eugene Rimmel developed a cosmetic using the newly invented petroleum jelly. The name Rimmel became synonymous with the substance and still translates to “mascara” in the Italian, Portuguese, Spanish, Dutch, Turkish, Romanian, and Persian languages today [8].

Across the Atlantic Ocean and at roughly the same time, in 1913, a man named T. L. Williams created a remarakably similar substance for his sister Maybel [9]. Later in 1917, T. L. Williams started a mail-order business from the product that grew to become the company Maybelline [6].

The mascara developed by these two men consisted of petroleum jelly and coal in a set ratio [8]. It was undeniably messy, and a better alternative was soon developed. A dampened brush was rubbed against a cake containing soap and black dye in equal proportions and applied to the lashes [10]. Still it was extremely messy. No significant improvement occurred until 1957 with an innovation by Helena Rubinstein.

The events leading to Rubinstein’s improvement began in Paris in the early 1900s. There, at the fashion capital of the world, mascara was quickly gaining popularity and common usage [11]. Elizabeth Arden and Helena Rubinstein, two giants in the American beauty industry, watched and kept abreast of its development. After the First World War, American consumers became eager for new products [12]. Sensing an opportunity, both Rubinstein and Arden launched their own brands of cosmetics that included mascara. Through the efforts of these two rivals and public temperament, mascara finally gained respectability and favor in American society [13].

The invention of the photograph and motion picture launched mascara’s popularity and usage further forward in America. Motion pictures especially advertised a new standard of beauty and sex appeal [14]. Famous actresses of the classic cinema era, such as Theda Bara, Pola Negri, Clara Bow, Greta Garbo, Marlene Dietrich, Bette Davis, and Jean Harlow, depended heavily upon mascara for their glamorized appearances, which the average woman sought to mimic [15].

In 1933, tragedy struck. A woman known on court records as Mrs. Brown consented to have her eyelashes permanently dyed [16]. Unfortunately, the product, Lash Lure, used paraphenylenediamine, a chemical extremely toxic to the body, as the dyeing agent [17]. At the time, cosmetics were unregulated by the Federal Drug Administration, and the dangers of paraphenylenediamine were unknown [18]. Within hours of the treatment, Mrs. Brown began experiencing severe symptoms of stinging and burning eyes. By the next morning, Mrs. Brown’s eyes had developed ulcers which oozed and had swollen shut [19]. Use of Lash Lure resulted in blindness in Mrs. Brown and fifteen other women and also caused the death of another. It was only after the Lash Lure incident and several others like it, documented in Ruth deForest Lamb’s book entitled American Chamber of Horrors, that Congress granted the FDA the right to regulate cosmetics in 1938 [20].

Years later in 1957, Rubinstein revolutionized mascara. She created a formula that evolved mascara from a hard cake into a lotion-based cream. She packaged the new mascara in a tube to be sold with a brush. For use, the cream was squeezed onto the brush and applied to lashes [21]. Although still messy, it was a progressive step towards the modern mascara product.

Soon, a grooved rod was patented. The ingenious device picked up the same amount of mascara for each use. The grooved rod was swiftly altered to the brush similar to the ones used today. The change in applicator led mascara to be even easier to use, and its popularity soared to its present heights

Etymology

Etymology

Exactly where the word “mascara” comes from is unclear, but it is most frequently thought to be based from the Spanish word máscara meaning mask or stain and the Italian word maschera meaning mask [1]. The Oxford English Dictionary also cites an alternative Catalan definition that describes soot or a black smear, or a Portuguese root with a connotation of stain or smut. There is even strong support for a possible source from the Arabic word maskharah or buffoon

Surgery


Surgery

Transplant operations are performed on an outpatient basis, with mild sedation (optional) and injected local anesthesia, which typically last about six hours. The scalp is shampooed and then treated with an antibacterial agent prior to the donor scalp being harvested.

In the usual follicular unit procedure, the surgeon harvests a strip of skin from the posterior scalp, in an area of good hair growth. The excised strip is about 1–1.5 x 15–30 cm in size. While closing the resulting wound, assistants begin to dissect individual follicular unit grafts from the strip. Working with binocular Stereo-microscopes, they carefully remove excess fibrous and fatty tissue while trying to avoid damage to the follicular cells that will be used for grafting. The latest method of closure is called 'Trichophytic closure' which results in much finer scars at the donor area.

FUE harvesting negates the need for large areas of scalp tissue to be harvested and can give very natural results with little or no scarring.

The surgeon then uses very small micro blades or fine needles to puncture the sites for receiving the grafts, placing them in a predetermined density and pattern, and angling the wounds in a consistent fashion to promote a realistic hair pattern. The assistants generally do the final part of the procedure, inserting the individual grafts in place.

Hair transplantation

Hair transplantation


Example of a graft transplantation. (scar of a Hidradenitis suppurativa operation on the back of the head.)

Hair transplantation is a surgical technique that involves moving individual hair follicles from one part of the body (the donor site) to bald or balding parts (the recipient site). It is primarily used to treat male pattern baldness, whereby grafts containing hair follicles that are genetically resistant to balding are transplanted to bald scalp. However, it is also used to restore eyelashes, eyebrows, beard hair, chest hair, and pubic hair and to fill in scars caused by accidents or surgery such as face-lifts and previous hair transplants. Hair transplantation differs from skin grafting in that grafts contain almost all of the epidermis and dermis surrounding the hair follicle, and many tiny grafts are transplanted rather than a single strip of skin.

Since hair naturally grows in follicles that contain groupings of 1 to 4 hairs, today’s most advanced techniques transplant these naturally occurring 1–4 hair "follicular units" in their natural groupings. Thus modern hair transplantation can achieve a natural appearance by mimicking nature hair for hair. This hair transplant procedure is called Follicular Unit Transplantation (FUT). Donor hair can be harvested in two very different ways;

1. Strip Harvesting - a strip of scalp is removed under local anesthesia, the wound is then sutured back together and this piece of scalp tissue is then cut in to small pieces of tissue called grafts which are then transplanted back in to the thinning area of the patients head. This method will leave a linear scar in the donor area, which should be covered by a patients hair (if long). The recovery period is around 2 weeks and will require the stitches to be removed by medical personnel.

2. Follicular Unit Extraction or FUE Harvesting - individual follicles of hair are removed under local anesthesia; this micro removal uses tiny punches of between 0.6mm and 1.25mm in diameter. Each follicle is then reinserted back in to the scalp in the thinning area using a micro blade. Because this is single follicles and no large amount of tissue is removed there is no visible scars or post-surgery pain, with no stitches to be removed. Recovery from FUE is within 7 days.

Perms and chemical straightening

Perms and chemical straightening

Perms and relaxation using relaxer or thermal reconditioning involve chemical alteration of the internal structure of the hair in order to affect its curliness or straightness. Hair that has been subjected to the use of a permanent is weaker due to the application of chemicals, and should be treated gently and with greater care than hair that isn't chemically altered.