December 2, 2019 Does Microneedling Help Treat Melasma?
If you’ve been keeping up to date with the skincare industry, it is almost inevitable that you have come across the term ‘microneedling’. Online articles about microneedling will state that its benefits include making you look younger, reducing acne flares, helping with pigment changes in the face, and even reducing hair loss. But what is microneedling, and can it help treat melasma?
What Is Microneedling?
Microneedling appeared on a lot of people’s radars after Kim Kardashian uploaded a photo of herself having what she called a ‘vampire facial’, where she underwent microneedling on her face along with a procedure called PRP (‘platelet-rich plasma’ – an extract from a patient’s own blood that is then applied to the skin).
Microneedles are exactly what they sound like – very small needles. They typically measure 0.1–1 mm in length, although they can be much larger (2-3mm). They can be solid needles or hollow, and there are also newer versions of microneedles that stay in the skin and dissolve (these are typically coated with medication and are not as commonly used in cosmetic procedures).
To understand the rationale behind using microneedles in cosmetic skincare procedures, we have to appreciate some basics about the layers of our ski:
- The outermost layer of our skin, the part that we can feel, is known as the ‘stratum corneum’. This is made up of largely dead skin cells that are packed together in a compact layer, with some cells continuously being shed and new ones coming from beneath to replace them. This is a very useful feature of our skin, as it prevents water loss from the deeper layers, prevents bacteria from getting in to cause infection, and protects us from certain allergens getting in and causing inflammation.
- However, the stratum corneum acts almost too well as a barrier when we are trying to deliver certain medications to the deeper layers of skin where we want them to have their anti-inflammatory or pigment altering effects. This is where microneedling is helpful. Using these tiny needles, we can create pores in the top layers of the skin (through the stratum corneum and most of what we call the ‘epidermis’) to reach the level of the ‘dermis’, which is the deeper layer of skin where the blood vessels and a lot of the inflammatory/pigment cells are located.
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Why Does Microneedling Help Our Skin?
Microneedling procedures can be split into two different types. One of these is where the microneedling itself is the only intervention, and the other is where the microneedling is then combined with the application of a topical medicine that penetrates through the newly created pores to the deeper layers of the skin. In the first of these types, the act of using the needles to penetrate the dermis has the beneficial effect of causing activation of cells called ‘fibroblasts’ that produce new collagen. As these cells produce collagen, the skin ends up looking fuller and visible wrinkles reduce.
In addition to the collagen-boosting activation of fibroblasts, the second type of microneedling treatment includes the opportunity for topical medications, such as skin lightening creams or anti-acne medications to use these pores to penetrate more easily into the skin than they would otherwise.
Does Microneedling Help Treat Melasma?
The use of microneedling by itself, without any other topical skin lightening creams, does not have a strong evidence base for improving melasma. As we know, melasma is a condition caused by a complex combination of photodamage and hormonal factors. Simply using the microneedles to activate fibroblasts in the dermis does not seem to be effective in isolation for the treatment of melasma.
The vast majority of studies that have been done about the use of microneedling for melasma have used it as ‘adjunctive’ treatment, meaning that microneedling is used alongside other interventions such as skin lightening creams containing a topical retinoid, vitamin C serums or hydroquinone creams.
In studies where microneedling was combined with skin lightening creams and routine sun protection, there is evidence to suggest that microneedling can help improve stubborn melasma. This makes sense when we consider that microneedles can form direct pores through the top layers of skin to deliver the medication into the dermis, where it can have its maximal effect.
A Word Of Caution
Inevitably, with the popularity of microneedling as a cosmetic procedure, there are now thousands of unregulated and unlicensed locations offering this treatment, often at cheaper rates than those available at the offices of board-certified dermatologists.
There are also many microneedling devices that are available for direct sale online for people to use on themselves at home. While it can be tempting to make use of these options, it is very important to do your research and make sure that the person carrying out the procedure is qualified to do it, and that the products you may purchase safe.
Melasma is most common in people with skin of color, and the risk of getting ‘post-inflammatory hyperpigmentation’ (darkening caused by trauma to the skin) is highest in those with this skin tone. Using inappropriately deep microneedles or unsafe techniques can result in post-inflammatory hyperpigmentation and worsen the appearance of melasma so please bear this in mind!
About the author
Brandon Kirsch, MD, FAAD, is a board-certified dermatologist specializing in clinical drug development and medical innovation. He is the founder of Kirsch Dermatology in Naples, Florida and is also the Chief of Dermatology at the ...