Mesotherapy and PRP: What Is the Difference?

Both Are Given as Micro-Injections; the Difference Is in What Is Injected

Mesotherapy and PRP often come up together at consultations. This is not because they are the same thing, but because they are given in the same way: in both, a fluid is delivered into the skin through many small injections with fine needles. From the outside, the two procedures look alike.

The similarity is in how they are given, not in the fluid itself. In mesotherapy, the fluid drawn into the syringe is a mixture prepared outside the body. In PRP, the fluid is obtained from blood taken from you at the start of the procedure.

This distinction matters more than it may seem, because the difference in preparation also directly determines how the fluid acts in the tissue.

There is also a point where the two methods meet. Studies reviewing PRP treatments in dermatology note that one of the ways PRP is delivered into the skin is the mesotherapy technique. In other words, the word ‘mesotherapy’ is sometimes used as the name of the substance being injected and sometimes as the name of the delivery method; some of the confusion comes from this.

What Is Injected in Mesotherapy

Mesotherapy is the delivery of medicines and vitamins into the middle layer of the skin through very small injections (micro-injections). The aim is to place the substance close to the target tissue. Studies report that this route increases how effectively the substance is used where it is applied (local bioavailability), while reducing the amount that reaches the rest of the body.

The contents of the mixture are not fixed; they vary depending on the problem being treated. In studies of injection treatments for hereditary hair loss (androgenetic alopecia), multivitamin and peptide mixtures were tried most often, followed by dutasteride, minoxidil, bicalutamide, growth factors and finasteride. The technique is not fixed either: needle type, injection depth and dosing schedule differ from study to study.

Mesotherapy is not used only in dermatology. Consensus statements (recommendations prepared by shared agreement) also list pain management, sports medicine, rehabilitation and vascular diseases among its areas of use. International consensus recommendations have recently been published so that the treatment can be carried out safely and in a standardised way. One of these consists of 49 recommendations prepared through a structured process called Delphi, and sets out what should and should not be done, from terminology to clinical use. One of its stated aims is to separate practices supported by evidence from those that are no longer considered valid.

How PRP Is Prepared

PRP is prepared from your own blood. The procedure starts with taking a blood sample. The blood is spun in a centrifuge; its components separate according to their density, and the platelet-rich layer is collected. This is the fluid that is injected.

How the centrifugation is done determines the final product. PRP is classified by the amount of white blood cells (leucocytes) it contains, its fibrin structure (fibrin is the protein that forms the clot network) and its platelet concentration. According to research, preparation methods such as single-spin centrifugation, double-spin centrifugation and the buffy coat technique (the buffy coat is the thin layer that forms between the plasma and the red blood cells after centrifugation) change the composition of the final product. What changes is the ratio of these components to one another: platelets, leucocytes, plasma proteins and extracellular vesicles (tiny sacs released by cells).

Classification systems have been developed to reduce this variability; the aim is to be able to describe what a preparation is in a way that can be compared. The very fact that these systems are needed shows that there are real differences between preparations.

In short, PRP is not the name of a single product. Two preparations with the same name can differ in what they contain.

What Growth Factors from Platelets Do

The main cargo platelets carry is biologically active molecules stored in tiny compartments inside them called alpha granules. These include platelet-derived growth factor, transforming growth factor beta, vascular endothelial growth factor and insulin-like growth factor.

These molecules do not work alone in the tissue. According to research, growth factors released by platelets stimulate the formation of new blood vessels and the production of the supporting tissue between cells (the matrix). Leucocytes regulate the immune response, plasma proteins provide support like a scaffold, and exosomes (tiny sacs released by cells) regulate signalling between cells. Together, these components create an environment for repair.

Researchers have also looked at which pathways are involved in the scalp. In hereditary hair loss, PRP is reported to work through blood vessel formation and also by activating intracellular signalling pathways known as Wnt/beta-catenin, MAPK, Akt/ERK and Notch.

The research also includes a caution: the platelet count alone does not predict the result. How well the platelets function is determined by the person’s age, metabolic state and level of oxidative stress (wear and tear caused in cells by free radicals). Whether these molecules are preserved during preparation is determined by the centrifuge settings, temperature control and activation method. In other words, two equal amounts of fluid may not carry the same biological load.

The Difference in Mechanism, in One Sentence

The difference can be summed up in one sentence: in mesotherapy, an active ingredient chosen from outside the body is delivered to the tissue, and the expected effect is that substance’s own effect; in PRP, a mixture of signals separated from your own blood is delivered, and the expected effect is the tissue’s response to those signals.

This is why the answer to the question ‘what is being injected?’ comes from a different place for each method. In mesotherapy, the doctor giving the treatment decides the contents; which substance is injected, and at what depth, is a choice. In PRP, the contents are largely determined by the person’s own blood and the preparation method used; the choice lies not in the substance itself but in the preparation protocol.

The difference also affects whether the procedure can be repeated in the same way. In mesotherapy, the same mixture can be prepared in the same way every time; what changes is the application technique, not the substance itself. In PRP, the source is living tissue: because of factors such as the person’s age, metabolic state or the preparation conditions, a different preparation can result at different times, even in the same person. This is seen as one of the obstacles to standardising PRP.

So it is more accurate to think of the two not as interchangeable options, but as different answers to different questions.

What Research Says About Hair Loss

The most researched condition is hereditary hair loss (androgenetic alopecia), but the picture is not equally clear for the two methods.

For PRP, there are large reviews that bring many studies together. One analysis pooling 43 randomised trials (trials in which participants are randomly assigned to groups) and 1,877 participants reports that, compared with placebo (a dummy treatment), activated PRP increased hair density and reduced the return of hair loss (relapse), but did not make a significant change to hair thickness. According to the same analysis, whether or not PRP is activated affects the response; this points to the importance of the preparation protocol.

Another analysis, comparing PRP with minoxidil applied to the skin, examined data from nine randomised trials and 451 participants. It found no clear difference between the two treatments in key outcomes such as hair density, terminal hair count (thick, mature hairs) and moderate-to-high hair regrowth; patient satisfaction, however, was higher in the PRP group. The researchers stress that, because the differences between studies are large (high heterogeneity), larger studies with standardised protocols are needed.

For mesotherapy, the evidence is more limited. A systematic review of injection treatments (a study that searches for and examines the research on a topic according to set rules) assessed 30 studies; the reported results ranged from increased hair density and hair thickness to hair loss stopping. However, its conclusion is cautious: because participant numbers were small, protocols varied and follow-up periods were short, randomised trials with standardised protocols are needed before injection treatment can be routinely recommended.

None of these studies invalidates the other method; each also clearly states its own limitations.

What Research Says About the Skin

There are fewer studies on the skin. One analysis of the effect of PRP on skin ageing, pooling nine randomised trials and 358 patients, reports a significant difference compared with the control group in both patient satisfaction and objective assessment. There was no significant difference between the two groups in how often side effects occurred.

The uses of mesotherapy for the skin are covered in international consensus statements. These statements were prepared because, although the treatment is widely used around the world, there is no internationally accepted, evidence-based standard for its various clinical uses. The aim is to move the practice away from personal opinion and onto an evidence-based footing. They also set out their own limits: high-quality research and regular updates are still needed in this field.

In short, for the skin, the available data for both methods point in a direction rather than giving a definite conclusion.

Why the Results of the Two Methods Cannot Be Compared Directly

The most important point to know is this: the results of the two methods cannot be compared directly, because the things being compared are not the same.

For PRP, the problem is that protocols differ from study to study (protocol heterogeneity). Research on PRP in hereditary hair loss clearly states that differences in centrifugation, activation and application protocols lead to inconsistent results between studies. Research on regenerative methods reaches the same conclusion: in recent studies, cellular composition was reported inconsistently, follow-up periods were short, and there are no data comparing treatment protocols with one another.

The problem also relates to the device used for preparation. Studies on PRP devices in dermatology state that the centrifugation protocol, device design and application technique affect platelet concentration, safety and the clinical outcome.

Mesotherapy has the same problem, but from a different source: what varies is not the preparation but the substance injected itself. Because needle type, depth and dosing schedule also vary from study to study, the studies grouped under the name mesotherapy describe not a single treatment but a family of treatments.

In practice, this means that a result obtained in one study cannot automatically be applied to a treatment carried out with a different protocol. For this reason, it would not be right to give a general success rate, number of sessions or duration of results for either method.

How Side Effects Are Considered

Side effects are also assessed separately for each method.

In research on injection treatments for hair loss, the adverse effects reported are generally mild. However, conditions such as paradoxical alopecia (hair loss after treatment, the opposite of what was expected), scarring and acute dermatitis (skin inflammation that starts suddenly) have also been reported. Studies comparing mesotherapy with minoxidil also note that local side effects and reactions related to the treatment can develop.

For PRP, the large analysis on hair loss reports that adverse effects were more common with non-activated PRP. This means the way PRP is prepared changes not only the expected effect but also its safety profile. In the analysis of skin ageing, there was no significant difference in how often side effects occurred compared with the control group.

None of these findings is a substitute for an individual risk assessment. Which risks are most relevant for you is assessed at your consultation, together with the medicines you take and any medical conditions you have.

One point applies to both methods: in any injection treatment, the risk comes as much from the technique itself as from the substance injected. This is also why research on injection treatments examines injection technique as a separate topic.

Limits of This Article

There are four limits to keep in mind when reading this article.

The first is scope. This article explains what the two methods are and what they do in the tissue, not who they are suitable for. Whether they are suitable for you is decided at a consultation, not by an article.

The second is the limits of the scientific studies themselves. Almost all the reviews mentioned here point to the same shortcoming: the studies have few participants, the protocols vary and follow-up periods are short. This does not mean the methods do not work; it means that current data are not enough to rank them definitively.

The third is the comparison itself. The reviews examined do not point to large studies that compare the two methods directly using standardised protocols. So there is no answer, based on scientific sources, to the question of which one is better. What can be done is to explain the two separate mechanisms separately and accurately; that is the aim of this article.

The fourth is time. The information here is based on the reviews available when this article was written. This field is constantly changing; as new reviews are published, this information will also need to be revisited. That is why the date of an article also shows how far it is still valid.

Treatments Offered Here

The clinic offers mesotherapy for both the skin and the hair. When it is considered and how its contents are chosen are assessed at a consultation.

Facial Mesotherapy and Hair Mesotherapy are covered separately on their own treatment pages; this article does not replace those pages and is written to be read before them. What you read here is not a decision but the groundwork for your decision. Once you understand the methods, you decide what to do next.