Consensus statement on mesotherapy for clinical and regulatory practice.

Mesotherapy is an evidence-based, minimally invasive technique used across multiple clinical fields, including pain medicine, sports medicine, rehabilitation, vascular diseases, dermatology, and aesthetic medicine. In recent years, international consensus recommendations have been developed to guide its safe and standardized application. To identify essential criteria for good clinical practice in mesotherapy and to promote their adoption among healthcare professionals and health authorities through a secondary analysis of the current recommendations issued by the Italian Society of Mesotherapy. A multidisciplinary panel of experts reviewed existing evidence-based recommendations and related scientific literature through a structured Delphi process. The analysis aimed to identify key elements that ensure safety, efficacy, and consistency in mesotherapy practice, and to distinguish evidence-supported interventions from outdated or inappropriate procedures. The expert panel formulated 49 evidence-based recommendations covering terminology, clinical use, and ethical aspects. Recommendations reached a high level of agreement (92.6%), confirming the robustness and clinical relevance of mesotherapy. The resulting standards clearly define what should and should not be done in modern mesotherapy practice. Adherence to evidence-based recommendations promotes transparency, patient safety, and professional accountability, while supporting regulatory recognition of mesotherapy as a scientifically grounded therapeutic option. These guidelines provide a framework for standardizing clinical practice, guiding education and research, and ensuring appropriate integration of mesotherapy into individualized treatment pathways. These evidence-based recommendations support harmonization of mesotherapy practice and its recognition by health authorities.