Skin Care, Acupuncture Mesopuncture Points, Mesotherapy.

The skin is the vector that allows applying different types of treatments, with/without injections, in medicine, aesthetic or beauty care: Mesotherapy, massage, ointment, botox, hyaluronic acid, laser, beauty care, aesthetic medicine, etc.

Often, the treatment applied in this particular area of the body, activates jointly the Acupuncture Points _APs located in the thickness of the skin, in this same area. 

In effect, in the thickness of the skin of the same area, are located Acupuncture Points _ APs, of systematized anatomic landmarks described for millennia, easily recognizable after a basic training.

They can be imperfectly stimulated by the same mode of treatment already applied.

It is interesting for adding an energy dimension to the already instituted treatment, to replace the incomplete and imperfect, because involuntary, stimulation of the APs by the usual and codified Acupuncture stimulation modes, as below, taking into account the location of APs.

In effect, we distinguish:

·                    Stimulation by a needle or by an external way (laser, massage, Moxas, micro currents etc.) which adds an energetic dimension to the instituted treatment. The effectiveness of this type of stimulation is of short duration, a few days.

·                    Stimulation by injection (or deposit, without needle) of a liquid drug into the

AP of local action (or Mesopuncture), introduces also, an energetic dimension by stimulating the AP due either to the volume injected into the AP or the chemical structure of the liquid drug.

The role of Acupuncture has been strengthened by Mesopuncture, activation (stimulation) of the AP by a liquid drug, injected by the same acupuncture needle if it is hollow (or by a specific device) or deposited at the surface of the skin, crossing it by iontophoresis (virtual Mesotherapy).

All around the AP, into the dermis, using the same technique, with/without needle and the same liquid drug, Mesotherapy Points _ PMs can be created: Indeed, the AP is described as a well beginning in the subcutaneous connective tissue and ending at the epidermis around which, may be created into the dermis and star-shaped, small reservoirs of few drops of the same liquid drug, which are the PMs. PAs and PMs are so close that they can be adjacent and made with the same needle and the same liquid drug.

The tangle of, topographical, technical and therapeutic fundamentals of Mesotherapy and Acupuncture/Mesopuncture, allows grouping them into one and the same treatment or MAM or Mesotherapy Acupuncture Mesopuncture, performed during the same visit. 

The Therapist can choose either to perform one of the components of MAM or the three components. In both eventualities it must be either:

·                    Entitled to inject liquid drugs. He can use a single and same needle, the BMN: Using a single needle insertion optimizes the needle insertion pain, it is an element of comfort for the Patient.

·                    Or not entitled to inject liquid drug: It must then use the iontophoresis that allows the liquid drug to cross the skin without using needles.

In summary, this triple treatment, the MAM, can be performed according two ways:

1.            Needle-free.
Moxas laser massage, etc. are used to perform Acupuncture and iontophoresis is used for Mesopuncture and Mesotherapy.

2.            With Needle (s).
Or a compact acupuncture needle and a hollow needle for injection in Acupuncture and Mesotherapy.
Or for carrying out the MAM, a specific device, the BMN, is inserted into the skin.

The BMN, what is?
The BMN is a disposable device performing the MAM, once its reservoir is filled with a liquid drug with/without therapeutic activity and its needle is inserted into the AP. With the BMN, in addition to Mesotherapy the Therapist can carry out Acupuncture and Mesopuncture and the Acupuncturist in addition to Acupuncture can achieve Mesopuncture and Mesotherapy. 

Therapeutic N°1, by injection into Acupuncture Points_ APs or Mesopuncture.

Therapeutic by injection into Acupuncture Points_ APs or Mesopuncture.

Two Parts. PART (1).

         

Therapeutic by injection into acupuncture points is a method of treatment developed on the basis of acupuncture, combining traditional Chinese medicine and Western medicine. It involves injecting drugs into the points or areas of positive reaction. By injecting a solute of drugs into the acupuncture point it will produce sensations due to the physical and chemical stimulation caused by acupuncture and drugs which allows regulating the body’s resistance and thereby achieving the healing of ailments.(1)           Palpation of the Points                                   

Palpation points aims to detect abnormal change of meridians points, i.e. their expressions of positive feedback, using the touch sense of fingers, which is the basis for the diagnosis and treatment.

To practice palpation, we first leave the patient take a comfortable and natural position according to the regions to be palpate and asked him to relax the muscles. And then we palpate carefully and with patience the regions selected using the thumb and forefinger.
We can leave the finger slide on the skin, massaging it, pressing it point-by-point, or depressing it to determine if there are abnormalities (manifestations of positive reaction) in the connective tissue of the dermis and subcutaneous and deep tissue.

For example there are perhaps at the level of the meridians points, cords and nodules, large or small, soft or firm of different shapes (round, spindle-shaped or flattened). Hypersensitive or painful points by pressure can be found and the same for impastos, muscular-cutaneous depressions and modification of muscle tone, the change of the skin color can be also observed.

The scope of palpation includes, paravertebral points (Huatuojiaji), Shu points of the back located on the dorsal lumbar region, Mu points in the thoracic & abdominal region, points of the four members meeting the condition to be treated as well as Ashi points (painful points by digital pressure).

(2)          Treatment technique

1.                 Choice of points.

a.             By palpation of the fingers, are chosen the points having the most remarkable reaction as key points for treatment.

We should know to avoid choosing too many points in a single session. It is important to accurately locate the selected points… If the positive reaction is not very clear, we can choose the corresponding meridian points.

b.             We choose the points as is done in regular acupuncture. But the points of the hand and foot as well as areas where there are not many soft parts are less-used. 

2.                Operative technique.

Prior to treatment should be explained to the patient characteristics of the therapeutic process and reactions that may occur when processing such as feelings of swelling, heaviness or weariness. 

Therapeutic N°2, by injection into acupuncture points or Mesopuncture.

Therapeutic by injection into acupuncture points or Mesopuncture.

Two Parts. PART (2).

Some patients may feel a sensation of heat.

After usual disinfection of the determined point, we take a charged syringe and inserted its needle into the acupuncture point to a desired depth or until the appearance of a certain acupuncture sensation. Then, if by pulling slightly the piston, no trace of blood appears in the syringe, then we will be able to inject the drug into the AP.

Manipulations vary according conditions to be treated. In most cases the injection is made at an average speed. For debilitated patients with chronic disease injection should be slow and  more diluted medicinal solution, while that for  patients of strong constitution, injection should be fast with more concentrated solution.

3.                    Choice of medication

The drugs used must be easily absorbable and without side effects. In addition to pharmacological effects, they must still present some irritant properties to extend the effect of acupuncture.

The usual drugs are:

a. Placental extract: It is stated in common diseases. It is often prescribed in the treatment of chronic hepatitis, nephritis, gastric ulcer, allergy reactions, neurosis and certain gynecological disorders reactions.

b. The solutes of Vit.B1, Vit.B12 and Vit.C, are indicated in chronic diseases and elderly and debilitated people. The sensation produced by the Vit.B12 is less pronounced than that determined by the Vit. B1. The Vit.C is indicated in hem bleeding tendency and cardiovascular diseases...

c. Drugs responding to disorders such as penicillin, Streptomycin and sulfate of magnesia.

d. Some medicines of traditional Chinese medicine such as injectable aqueous extracts of Radix angelicae and Flos Carthami can also be used.

e. the intradermal injection of distilled water alone is painful and can provide a physical stimulation without side effects. It is suitable in certain diseases. Injection should be fast because the duration of produced acupuncture sensation is fleeting.

(3)          Remarks

a. Account must be taken of incompatibilities, of allergic reactions and side effects of drugs used. Skin Allergy tests should be performed prior to use drugs of antigenic properties. The injection will be made only when the test is recognized negative.

b. Carefully follow the dosage and concentration of injectable solutions. They vary depending on the disease state and regions to treat. In general for the region cephalo-facial (rarely chosen region), we would use medicated fluids at low concentration, less irritating, the dosage should be reduced with a slow injection. For regions of the trunk, drug solute must be more concentrated, stimulation may be stronger, the highest dose and rapid injection.

For Points of the four members we should not use drug solutes very concentrated or very irritating. But it is permissible to combine drug injection to acupuncture treatment..

c. In principle we retain to introduce solutes into articular cavities or blood vessels.

d. A large aseptic care will be taken to prevent any infections. For elderly and debilitated patients, are taken fewer points and for the first meeting, a smaller dose of solute will be injected.

e. Avoid the puncture of the viscera during injection into back points and more, precautions will be taken to avoid the needles discomfort, needles breaking and other potential accidents.
f. A session a day or every two days. A cure includes 7-10 sessions. The interval time between two cures is 4-7 days.

Translation of the published article, in French, in 1977 by Academy of traditional Chinese medicine in 'Précis  of Chinese Acupuncture ' Beijing. edition in foreign languages (French), Page 292. 

What is the interest of inserting the needle into the Acupuncture point,

What is the interest of inserting the needle into the Acupuncture point, for Acupuncture in general and facial aesthetics, in particular?

What is the interest in inserting the acupuncture needle into the #Acupuncturepoint, for acupuncture in general and #facial aesthetics, in particular?

There are some years in France, the Acupuncture_ point AP has been described as a well, beginning in the connective tissue and opened at the surface of the skin.

SOULIE de MORANT, the ‘inventor’ of acupuncture in the West, has attributed the sensitivity of the skin surface of the AP to the AP itself.

·                    Since short time, Pr. LANGEVIN, described the AP as a mass, a convergence of connective tissue cleavage planes. This mass corresponds, by careful palpation of the skin, to the anatomical details described by the Ancient, to assist in the localization of IPs: A slight depression, a hole, a node ... These anatomical details would, according to Pr. LANGEVIN, in reality, be an easy access to greater amounts of connective tissue…

According to the same source, we also know that the volume of connective tissue in the AP allows a stimulus of greater intensity, an acupuncture effect of 'higher intensity knowing that the needle inserted at any point of the skin also produces an acupuncture effect ', but of lesser intensity.

Another feature of APs is, according to Pr. LANGEVIN, the alignment of collagen fibers in the APs, after the stimulus.

Acupuncture is active also in the other component of the connective tissue, the extracellular matrix, which allows the signal produced by stimulus of the needle or liquid drug, to be transmitted from one AP to another AP and for production of the acupuncture effect as described in Chinese medicine.

Stimulus of the connective tissue to stimulate the skin trophicity is part of the essential objective of any aesthetic treatment, particularly in facial aesthetics. This is the acupuncture main role.

Stimulation by the needle insertion must be repeated after a short period: Two to three days.

The fluid stimulus duration by a commonly used liquid medicine is dependent on its physicochemical structure: Duration more or less identical to the needle stimulus.. But in facial aesthetics, stimulation by a liquid drug commonly used, can, besides its therapeutic role in aesthetic recognized by the pharmacopoeia, have also a stimulus role of the AP, lasting the duration of its elimination from the human body, that is to say several months, 

Acupuncture was the first science using stimulation of the connective tissue to treat various conditions, including aesthetics.

If the metal needle was the first stimulating mode, since the end of the last century, Chinese medicine proposes the stimulus by a liquid drug or Mesopuncture, also.

 Microneedling also known as collagen induction therapy and Mesotherapy in its classical or nappage version, have adopted this mode of stimulus initiated by Acupuncture, but we don't have found any mention of fundamental anteriority of for the connective tissue stimulation by needle or liquid drug proposed and used in Acupuncture.  

In facial aesthetics, what to do, with the remaining hyaluronic acid?

In facial aesthetics, what to do, with the remaining hyaluronic acid?

Activate, by micro doses the Acupuncture Points or Mesopuntura, of the face?

It should be remembered that, for the most part, the aesthetic treatments, of the face in particular, have as objective to consolidate the trophicity skin by stimulating the connective tissue: The fundamental substance as well as the elastin and collagen fibers.

Since decades, the therapeutic properties of Acupuncture on the different parameters of facial aesthetics are recognized internationally.

·                    According to classical acupuncture theory, 

Acupuncture points_ APs are interconnected in a network of meridians extended longitudinally along the surface of the body, connecting the peripheral tissues, between them and to the internal 'organs'.

APs, of systematized (sometimes random) location have specific therapeutic properties allowing to divide APs into three classes, depending on the extent of the therapeutic action, in APs of general, regional or local action. Only these last APs of local action, that do not require extensive knowledge in Acupuncture, are involved in this article.

Currently it is emphasized that the great similarity between on the one hand the connective tissue structure and on the other hand the meridians and APs network, allows involving the connective tissue, both in the components of acupuncture and the mode of action of acupuncture.

The meridians are considered to be cleavage plans of connective tissue and the APs heaps of connective tissue of privileged and easy access from the skin surface through APs, whose systematized location in the skin was described by the elder.

It is considered that activation of the APs, necessary for its efficiency, is in reality, activation of the peripheral and specialized connective tissue, performed by a path starting from the skin, the AP, giving a direct and safe access to the connective tissue,.

Activation is carried out by a needle or by a liquid drug. 

The 'Acupuncture' effect is notable, in all the connective tissue surrounding the AP, but is more evident at the level of the AP (5 mm diameter)... after the stimulation, is noted, microscopically, an alignment of collagen fibers in the AP.

By a needle inserted in the AP but the activation time lasts few days and implies a new needle insertion.

By a liquid drug injected (or deposited without needle): Duration of the activation depends on the elimination rate of the liquid drug from the body: It is of very long duration for hyaluronic acid delaying at the same time a new needle insertion.

For activation by other liquid drugs: Each liquid drug has a duration of action described in the Pharmacopoeia, corresponding to the duration of AP stimulation. The activation period is variable and depends on the physicochemical structure of the liquid drug with this characteristic proper to local injections of drug:

·                    The locally injected liquid drug first reaches directly the area of the altered skin without passing through the liver, and then in a second time, after passage in the liver and conjugation, reaches again the altered zone.              

What is Mesopuncture? N°1

What is Mesopuncture? N°1

It is the liquid drug in Acupuncture point, with the BMN device or iontophoresis process. Mesopuncture detailed.

#Mesopuncture is the deposit of few drops of a neutral or active liquid drug, either by injection or passive deposit into the Acupuncture Point _ AP. It is a version of treatment, proposed by Chinese medicine, accompanying in general the classical Acupuncture.

It is the drug in acupuncture with BMN or iontophoresis.

Practicing Mesopuncture is an unexpected opportunity to associate acupuncture and Mesotherapy, western-based drug delivery technique, but it would need a triple needle insertion.

To promote this benefit for the patient, it was necessary to optimize the three needle insertions pain, it is what BMN allows with a single needle insertion into the skin: It has appeared appropriate to take advantage of the already needle inserted to extend its role and, at the same time,

· To add a metallic stimulus or acupuncture to liquid stimulation or Mesopuncture. 

· To perform thus Mesotherapy Points _ PMs by, passive or active deposits in the dermis or hypodermis around the AP, of few drops of liquid drug either using the BMN needle and its reservoir or the iontophoresis apparatus.

The BMN is the ideal device that allows to optimize the needle insertion pain and take advantage of, (thanks to its reservoir, the handle of the needle, of drug included in its structure), the needle inserted into the AP, to perform with this same insertion, both Mesotherapy and Acupuncture- Mesopuncture or MAM.

This mode of treatment, injecting or depositing a drug in the PA or Mesopuncture, proposed by Chinese medicine, fell into oblivion in the West.  Its rebirth, in the West, favored by the BMN concept, was started by #Bleu Medical, Fr, and published on the Internet with the title #Mesopuncture held by a web: www.mesopuncture.com

This Internet publication was followed by a multitude of Internet sites, with different titles but always after our web about the use drugs in the AP.

Some answers to the questions the therapist may ask himself about Mesopuncture:

If initially, the liquid drug was injected, only by needle, into the AP, the use of iontophoresis has allowed later to describe a needle-free version.

At what point of the acupuncture consultation, Mesopuncture is performed?

The Mesopuncture is fully integrated into the classical acupuncture consultation before, during or after insertion of the conventional acupuncture needles which must remain in situ for about twenty minutes.

What is the diameter of the acupuncture needle and injection hypodermic needle?

• Usually, the Acupuncture needle diameter is 0.3 mm. The injection needle diameter is 0.45 mm.

Is diameter the only criterion for the needle to be qualified as acupuncture needle?

Normally, the acupuncture needle diameter is 0.30mm there are, but rarely indeed, acupuncture needles with a finer diameter.

It is not the exclusive criteria to define the acupuncture needle. This is the need for the needle to have a handle allowing the Therapist to perform acupuncture.

&&&How is the liquid drug selected?

It is selected in the pharmacopoeia according to the health or aesthetics disorder, presented by the Patient.

It is a liquid drug, already used in daily practice, preferentially intravenously or intramuscularly more rarely.

The liquid drug is then divided into micro-doses, injected or deposited, by needle or iontophoresis, into the AP for Mesopuncture and into the dermis around the AP, to create, in this case, Mesotherapy Points_ MPs.

Both actions can be realized during the same session with the same injection vector, the BMN.

What the advantage is of associating acupuncture and Mesopuncture?

The drug acts both by its own therapeutic action recognized by the International Pharmacopoeia or 'Pharmacological effect' and as an own stimulus of the PA producing an 'Acupuncture Effect', both effects due to the physicochemical structure of the drug.  These two actions are added to the classic 'acupuncture needle' stimulus.

The medication acts by both 'Pharmacological effect' and ' Acupuncture Effect ', two effects due to physicochemical structure of the drug. These two actions are added to conventional stimulation with an acupuncture needle.

What is Mesopuncture? N°2

What is Mesopuncture? N°2

It is the liquid drug in Acupuncture point, with the BMN device or iontophoresis process. Mesopuncture detailed.

Advantages of combining Acupuncture and Mesopuncture

         First these two actions can be carried out during the same consultation with the same injection vector, the BMN.

         It seems moreover, that the most tangible benefit of using the medicine in Acupuncture is the possibility to act on the length of the ‘Acupuncture Effect’ like the titanium implants in Auriculoterapia or the catgut burial into the APs.

A drug in AP, injected or deposited, is a more practical way.

Certain drugs can lengthen stimulation duration of the AP in a tangible way.  Is it that the two actions of the drug can be separated on the one hand the 'Pharmacological Effect' and on the other hand the 'Acupuncture Effect ' and especially the duration of this effect?

o   Hyaluronic Acid is known to have an action of 'comfort' in aesthetics, without major adverse effect described on health but of lasting action, several months.

In the AP, the HA produces an Acupuncture Effect, of same duration as the 'Pharmacological Effect' but in this case, the possible improvement of aesthetic problems, would not be an obstacle to the use of HA to get a prolonged Acupuncture Effect during several Months.

It is a virtual separation between the 'Acupuncture Effect' and the 'Pharmacological Effect' both held by the physicochemical structure of the drug. 

o   Is it that all drugs are eligible?

 All drugs are eligible, including the drug without notable, as distilled water or saline, therapeutic activity...

o   How to optimize the double needle insertion pain, knowing that if it is acceptable for an AP, it becomes uncomfortable when it comes to several APs?

Saving the insertion of multiple needles at the same point and privileging the use of a single and same needle inserted in the same AP, are two solutions

 *-* Or choose the needleless acupuncture-Mesopuncture version: La Mesopuncture performed by Iontophoresis and Acupuncture by massage, heat waves etc.

*-* Either the BMN is used, it is the best solution: the BMN is a simple device, an acupuncture needle, 0.3 in diameter, hollow, topped by a reservoir running as a dropper, filled/emptied according to two fingers pressure on the reservoir. It does not prevent dorsal or ventral decubitus. The needle is inserted into the PA, it will remain twenty minutes after which, are injected few drops of the drug filling the reservoir not only in the AP but also, in the dermis around the AP to create Mesotherapy Points _ MPs.
The BMN with one and the same insertion of the same needle has allowed the realization of both versions of Chinese medicine and a new way of injecting drugs, Mesotherapy.   

o   Why BMN is an acupuncture needle, however?

Because to be an acupuncture needle, the needle must have a handle and precisely the reservoir is the handle necessary to properly perform acupuncture.

o   How is the consultation developed?

The BMN needle is inserted into the AP, the patient’s consultation is followed in any decubitus. 
At the end of the time needed to the stimulus of the needle, inserted in the AP, to be complete (20 minutes), a few drops of the contents of the reservoir are injected into the AP for the liquid stimulus or Mesopuncture.

 Knowing that MPs are created in all part of the dermis even around the AP, some drops of drug from the BMN reservoir are injected, around the AP, in the dermis according to a star shaped, to create multiple drug reservoirs which are the MPs: it has been able, in this way, to perform the Mesotherapy Acupuncture Mesopuncture set or MAM with a single insertion pain of a single needle, in the skin.

BMN helps to optimize multiple needle insertion pain.