What is pigmentation mesotherapy?
In pigmentation mesotherapy, products considered appropriate for changes in the colour of the skin are applied to the determined layer of the skin using the mesotherapy technique.
The Mesotherapy Application Guideline (opens in a new tab) (Mezoterapi Uygulama Kılavuzu) of the Ministry of Health of the Republic of Türkiye counts discolouration and similar skin diseases among the indications for mesotherapy. As defined in the Guideline, mesotherapy is a method applied “by injecting herbal or pharmacological products in small doses, regionally and with special needle techniques, into the layers of the skin in sessions”.
The causes of discoloured patches differ from one another, and some are not within the scope of this procedure. The nature of the change in the colour of the skin is determined first, by examination; no procedure is performed without a diagnosis.
The procedure may be performed only by physicians holding the relevant certificate, at premises authorised by the Ministry (opens in a new tab).
Diagnosis first: which discoloured patches are not within the scope of this application?
In the following situations, a dermatology assessment is required before mesotherapy is even considered:
- A patch that is changing in colour, border or size
- A lesion with an irregular border, containing more than one colour, or asymmetrical
- An area that is bleeding, crusting or not healing
- A patch that itches or is painful
- A lesion that has appeared over a short period or is growing rapidly
- A change in colour appearing under a nail, or on the palm or the sole of the foot
- A newly appeared patch that does not resemble the earlier ones
If any of these findings is present, the procedure is not carried out; the patient is referred to dermatology. The differential diagnosis of skin lesions falls within the field of dermatology and cannot be postponed.
In addition:
- In changes in colour that develop in relation to a medicine, the medicine concerned must be reviewed first
- In discolouration accompanying a hormonal presentation, the underlying condition must be assessed
- Where the presentation is widespread loss of colour, this is a different matter altogether, and a dermatology assessment is required
When is the procedure considered?
The decision on suitability is made after the examination and the diagnosis. The assessment takes into account the type of discolouration, its duration, the skin type, sun exposure, current medication and any procedures previously performed.
In which patients is the procedure not performed?
The patient groups in whom the procedure cannot be performed under the Mesotherapy Application Guideline are listed below:
- In pregnant and breastfeeding patients
- In patients under 18 years of age
- In patients with an infection, an open wound or a rash in the procedure area
- In patients with an inflammatory skin disease or rosacea
- In patients in whom blood pressure or blood sugar control cannot be achieved
- In patients with advanced heart failure and/or a history of a heart attack
- In patients with advanced liver and/or kidney failure
- In patients taking warfarin
- In patients with a history of allergy to the product to be used
- In patients with an interaction between current medication and the product
- In patients with a history of epilepsy (not in remission)
- In patients with septic arthritis, and in patients in the active phase of a rheumatic disease
- In patients with a history of a cerebrovascular event, and in patients with a bleeding diathesis
- In patients with a body mass index above 30
- In patients with a diagnosis of AIDS
Under the Guideline, in oncology patients (with the opinion of the specialist physician primarily responsible for their treatment), in patients of advanced age and in patients during an acute attack of a chronic disease, the procedure is performed with the opinion of the relevant specialist physician.
Additional conditions specific to this area
The procedure is not performed if the following are present in the area to be treated:
- A skin lesion that has not been diagnosed (a dermatology assessment comes first)
In these situations, the procedure is planned subject to the physician’s assessment:
- The use of medicines that cause photosensitivity
If there is active sunburn in the area, or if sun protection cannot be followed after the procedure, the procedure is postponed.
How is the procedure performed?
- Examination and diagnosis. The change in the colour of the skin is assessed. If there is a suspicious finding, the procedure is not carried out and the patient is referred to dermatology.
- Assessment. A medical history is taken; we ask about current medication (in particular medicines that cause photosensitivity), sun exposure and previous procedures. Blood pressure and pulse are measured.
- Information and consent. The procedure, the product to be used, the requirement for sun protection and possible side effects are explained in writing and verbally; the form is signed.
- Preparation. There must be no cream, moisturiser or make-up on the area. Antisepsis is ensured.
- The procedure. The product is applied to the determined layer of the skin using the mesotherapy technique.
- Observation. Vital signs and any side effects observed are recorded in the patient’s file.
How long does it take, and how many sessions are needed?
The Guideline states that, in procedures other than pain management, the intervals between sessions are between 1 and 3 weeks. The number of sessions cannot be given in advance as a single figure; it varies according to the type of discolouration and the person.
What should you do before and after the procedure?
Before the procedure, report:
- A list of all the medicines and supplements you use
- Whether you are using any medicine that causes photosensitivity
- Your pregnancy status
Come with no cream, moisturiser or make-up on the area. You are asked to avoid intense sun exposure before the procedure.
Afterwards, sun protection is a subject in its own right for this procedure:
- Sun protection is the most important rule after the procedure. Without protection, a change in colour may be seen in the skin
- You are asked to avoid direct sun exposure and sunbeds
- Redness, mild swelling and tenderness may occur; transient blisters may be seen at the points of application
- The Guideline describes mild oedema in the first 72 hours as an expected finding
- You are advised not to rub or scratch the area
Recommendations and time frames specific to you are given in writing at the end of the procedure.
Risks and side effects
Specific to this procedure
- A change in colour in the skin (in the direction of either darkening or lightening; this is why sun protection is an inseparable part of the procedure)
The unwanted effects reported by the Guideline fall under the following headings.
Related to the product
- Mild itching and redness
- With acid-based products, pain during the procedure; excessive pain sensitivity after the session
- In applications containing a corticosteroid, thinning of the skin (atrophy) and change in colour
Related to how the procedure is performed
- Oedema, pain and tenderness
- Pain due to an excessive amount of product
- Local infection where hygiene rules are not followed
Related to the injection entry point
- Bleeding, pain and tenderness
- Tenderness of the skin at the end of the procedure
Rarely seen situations for which a plan of intervention is set out in advance
- Allergic reaction
- Infection
- Tissue death (dermal necrosis)
- Vasovagal syncope (fainting)
- Raised blood pressure
- Oedema lasting beyond 72 hours, or excessive oedema
Results vary from person to person. The response varies according to the type of discolouration, and no guarantee of a result can be given.
When should you see a physician without delay?
If you experience these symptoms during treatment, contact your physician without delay:
- A change in the colour, border or size of a patch (this finding requires assessment regardless of how the procedure is going)
- Marked darkening or lightening in the procedure area
- Increasing redness, increased warmth, swelling or discharge
- A high fever
- Oedema lasting beyond 72 hours or increasing steadily
- Spreading bruising
- Widespread rash, itching
In the event of shortness of breath, swelling of the face or tongue, difficulty swallowing, altered consciousness or blanching of the skin, go directly to the emergency department.
Frequently asked questions
Can mesotherapy be applied to every discoloured patch?
No. The nature of a change in the colour of the skin is determined first, by examination. In lesions that are changing in colour, border or size, or that bleed, itch or grow rapidly, the procedure is not carried out; a dermatology assessment is required.
The patch on my skin is changing; what should I do first?
A change in the colour, border or size of a patch, or its bleeding or failing to heal, are findings that require assessment. If so, please consult dermatology before planning an aesthetic procedure.
Can I go out in the sun after pigmentation mesotherapy?
Sun protection is the most important rule of this procedure. You are asked to avoid direct sun exposure and sunbeds; without protection, a change in colour may be seen in the skin. Time frames specific to you are given in writing at the end of the procedure.
Does the patch go away completely?
No guarantee of a result can be given. The Guideline states clearly that, for mesotherapy, no statements may be made to the effect that it will eliminate a disease or treat it on its own. The response varies according to the type of discolouration and the person.
How many sessions are needed for pigmentation mesotherapy?
A definite number of sessions cannot be given in advance. The Guideline states that, in procedures other than pain management, the intervals between sessions are between 1 and 3 weeks.
Is pigmentation mesotherapy performed in pregnancy?
No. The Mesotherapy Application Guideline states clearly that mesotherapy is not performed in pregnancy or while breastfeeding.
Could the medicine I am taking be related to the discolouration?
Some medicines may lead to a change in the colour of the skin or to photosensitivity. This is why we ask for a list of all your current medication at the consultation and, where necessary, review it together with the physician concerned.
Sources
- Ministry of Health of the Republic of Türkiye, General Directorate of Health Services, Mezoterapi Uygulama Kılavuzu, Ankara, June 2025. https://ekutuphane.saglik.gov.tr/Yayin/694 (opens in a new tab)
- Ministry of Health of the Republic of Türkiye, Geleneksel ve Tamamlayıcı Tıp Uygulamaları Yönetmeliği, Official Gazette 28 April 2026 / 33237. https://www.resmigazete.gov.tr/eskiler/2026/04/20260428-2.htm (opens in a new tab)
