microneedling

A pilot study by Brazilian dermatologists demonstrates the beneficial skin changes seen in treating melasma with collagen microneedling.

Melasma afflicts up to a third of the female population of the child-bearing age. The hyperpigmentation that occurs over the face is due to an abnormal deposition of melanin. Natural pregnancy hormones and ultraviolet radiation are the most commonly identified culprits.

The classic approach to treating melasma entails addressing the pigment deposits and preventing further pigmentation. Clinicians use chemical peels or laser resurfacing to minimize the discolouration, with the prophylactic application of topical sunscreens expected to minimize subsequent sun damage. The success of this traditional regimen remains mixed at best, and patients are prone to recurrence of the symptoms.

A deeper understanding of the pathology of melasma shows that other skin cells apart from the melanocyte are involved; cells like fibroblasts also release substances that heighten the pigmentation response. Moreover, other changes are also seen in the skin, from thinning of the membranes to outright damage to many skin structures.

Dermatologists have been using microneedling techniques for skin rejuvenation, in which they inject minute amounts of collagen into the skin using tiny needles.  The injected collagen stimulates cellular growth and proliferation, repairing damages brought about by radiation or pigmentation. Tying this in with how melasma other cells and structures in the skin, clinicians are now looking at the potential of using collagen to treat melasma.

Can Collagen Microneedling Treat Melasma?

The BMC Journal of Dermatology recently published the results of a pilot study conducted by Brazilian dermatologists, where they incorporated microneedling procedures as an adjuvant treatment for recurrent melasma. The researchers chose six patients identified with recurrent melasma and offered microneedling with collagen as part of their treatment regimen. The clinicians not only followed the patients up for symptom improvement, they also performed skin biopsies to determine any beneficial effects that could be seen on the cellular level.

After the six-month treatment period, the researchers reported significant improvement of the melasma, with patients unanimously expressing satisfaction with the results—no recurrence was reported during this span.  More significantly, the biopsies revealed changes at the cellular level, from decreased melanocyte activity to the outright restoration of previously damaged areas.

If proven by more definitive studies, this could lead to the integration of collagen infiltration into the protocols for treating melasma. Adding the reparative properties of collagen may be the step needed in finally dealing with the therapeutic challenges of melasma.

Written by Jay Martin, M.D.

Reference: Lima, et al. “Assessment of the effects of skin microneedling as an adjuvant therapy for facial melasma:  a pilot study”. BMC Dermatology (2017) 17:14.  DOI:  10.1186/s12895-017-0066-5.

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