06 Nov Why Hyperpigmentation Caused by Microneedling
Unveiling the Relationship: Microneedling and Hyperpigmentation
The question of whether hyperpigmentation caused by microneedling has been a topic of ongoing discussion. A key consideration is the prevalence of “post-inflammatory hyperpigmentation” (PIH) in individuals with darker skin tones. Given that microneedling induces inflammation, one might wonder why it is not classified as “high risk” for these patients. The answer lies in the nuanced nature of the inflammation triggered by microneedling—both in terms of its degree and duration.
Managing Inflammation: The Microneedling Perspective
Microneedling is known to stimulate the production of TGF-B3, which exerts anti-inflammatory effects. Additionally, it promotes TGF-B1, restricting pigment formation by downregulating tyrosinase through decreased gene expression and a reduction in its intracellular half-life. Anti-inflammatory skincare ingredients, such as phosphatidylcholine, often used in conjunction with microneedling, further mitigate the inflammatory response. While there are other mechanisms at play in normalizing pigment formation through microneedling, they won’t be explored in detail here.
Navigating the Complexities of Hyperpigmentation
Addressing hyperpigmentation caused by microneedling is complex due to its multifactorial nature, making pinpointing a single cause challenging. Known factors like sun exposure, PIH, smoking, genetics, hormones, and photosensitizing medications are acknowledged, alongside lesser-known contributors to this intricate phenomenon.
Microneedling Dynamics: Beyond Colorblindness
Despite being touted as colorblind, microneedling’s impact extends beyond the procedure itself. When combined with elements like chemical peels, photosensitizers, and post-treatment sun exposure, hyperpigmentation may ensue. Microneedling is rarely performed in isolation, and external factors, such as unavoidable sun exposure and hormonal influences, complicate the scenario. Individuals on photosensitizing medications face additional challenges, and higher Fitzpatrick skin types exhibit heightened pigment production, making them more susceptible to post-treatment hyperpigmentation.
Deciphering the Microneedling Equation
In essence, microneedling, when performed in isolation, plays a role in regulating and normalizing pigment formation at both melanocyte and keratinocyte levels. It does not inherently induce hyperpigmentation unless influenced by other contributing factors.
Microneedling’s Unique Position
Microneedling stands as a proven treatment for optimizing skin health, offering superiority in various aspects compared to alternative modalities. However, like any procedure, it has its limitations.
Challenges and Cautionary Considerations
In the pursuit of maximizing results, practitioners often combine microneedling with other modalities. This synergistic approach, while potentially beneficial, necessitates an awareness of potential drawbacks. Microneedling, amplifying both positive and negative effects, may enhance absorption or inflammation when coupled with additional treatments.
A Cautionary Tale
Issues arise when practitioners push the limits, attempting to match the outcomes of those with broader scopes of practice. For instance, using cosmetic rollers and occlusion to boost the penetration of topical anesthetics can transform an over-the-counter product into a potent “drug” without prescription oversight. This not only compromises dose-level restrictions but also removes the protection intended for practitioners and clients in case of emergencies, such as cardiac arrest.
In conclusion, while microneedling remains a valuable tool in skin rejuvenation, practitioners must exercise caution, understanding its limitations and potential interactions with other modalities to ensure optimal outcomes and patient safety.