What exactly is chloasma, known as the “king of spots”? Chloasma is a common major pigmented disease, which is characterized by yellow-brown pigmentation spots on the face. Due to the significant changes in the life pressure and living habits of women in modern society, the incidence of chloasma is generalized, and the age of onset tends to be Rejuvenation.

          The diagnosis of chloasma is easy, but the treatment is difficult. A single photoelectric and drug therapy cannot treat chloasma very well. Topical drugs are often irritating to a certain extent, and strong photoelectric therapy often irritates chloasma. “Anti-black” phenomenon occurs. In recent years, microneedling therapy has been widely used in the treatment of chloasma, and its therapeutic effect has been recognized by many in the industry.

          The principle behind the treatment of melasma by micro-needling comes from the effective stimulation of the dermis by micro-acupuncture, and the dermis and subcutaneous tissue are derived from the mesoderm.

          Previous theories believed that skin pigmentation only occurred in the epidermis, but now more and more evidences show that the mesoderm-derived dermal tissue has an important regulatory effect on pigmentation. The researchers found that the production of neuregulin by fibroblasts can promote pigmentation, suggesting that dermal fibroblasts play an important role in regulating skin pigmentation.

          The regulatory effect of dermal lymphocytes on melanocytes, lymphocytes are deeply involved in pigmented skin diseases, and the performance results can be completely opposite, suggesting that the involved lymphocytes have different functional subsets. The diversity of lymphocyte subsets determines the diversity of cosmetic skin problems.

          Dermal blood vessels have a significant impact on the regulation of epidermal pigment, and the occurrence of chloasma is closely related to skin blood vessel dysfunction and abnormal hyperplasia.

          In the clinical research of microneedling therapy for chloasma, it was found that the histological section of chloasma skin treated with microneedling showed continuous thickening of epidermis, recovery of nuclear polarity in basal layer, melanin density and melanosome granularity A 5% reduction and a 32% increase in the keratinocyte proliferation rate indicated a comprehensive improvement in the clinical changes of melasma treated by microneedling.

          Clinically, microneedle therapy can promote the transdermal absorption of drugs, stimulate the body to release a variety of growth factors, promote the proliferation and migration of fibroblasts and collagen synthesis, so as to repair and rebuild the skin barrier and basement membrane in the skin lesions of patients with melasma At the same time, the expression of tyrosinase is regulated by introducing functional components to reduce pigmentation.

          The effect of micro-targeting on melasma is mainly exerted by the following three pathways:

          1.Micro-needle stimulates and promotes skin keratinocyte renewal through slight damage to the skin, rebuilds the brick wall structure, and repairs the skin barrier function;

          2.The micro-needle punches many micro-channels in the epidermis, through these micro-channels, the absorption of drugs can be greatly promoted, and the discharge of pigment particles can be promoted at the same time;

          3.Microneedle can stimulate the dermis tissue, rebuild the normal physiological structure of the dermis, which is beneficial to the regulation of pigment particle metabolism and vascular function.

          Precautions for the treatment of melasma with microneedling

          1.When choosing a needle roller, try to choose a needle roller of 1.5~2.0mm, so that the needle roller of this length can stimulate the epidermis and the upper dermis at the same time.

          2.Strict aseptic operation is required for microneedling treatment. The operation sequence is left cheek – forehead – right cheek – lower jaw – upper lip – nose, apply the medicine while rolling, and repeat 3 times in sequence (some doctors recommend not to repeat the operation , please combine with clinical treatment), the third pass can increase the rolling force in the local area of ​​the chloasma according to the specific skin conditions, after treatment, the skin is slightly red, and the chloasma skin lesion area is suitable for a little bleeding point. Note that when rolling, the direction of force should be consistent with the axis of the skin needle roller to prevent the skin needle roller from being broken or twisted.

          3.Microneedle can be combined with a variety of drugs to increase the curative effect, such as 1% tranexamic acid solution, human-like collagen, L-vitamin C solution, glutathione solution, nicotinamide, hydroquinone decolorizer and non-hydrogen Quinone decolorizers, etc. Drugs enter the skin quickly through the pores to exert their effects.

          4.Microneedle can be combined with a variety of photoelectric therapy, such as microneedle combined with intense pulsed light, microneedle combined with fractional laser, microneedle combined with Q-switched laser, microneedle combined with picosecond laser, etc. However, when using combined photoelectric therapy, attention should be paid to the adjustment of energy. Excessive or too concentrated energy may irritate melasma and make it worse. At the same time, more attention should be paid to postoperative repair and protection to avoid excessive treatment and damage to the skin barrier.

          5.In the treatment of melasma, it is often necessary to combine oral or even intravenous drugs, such as oral tranexamic acid 250 mg twice a day, combined oral/intravenous use of reduced glutathione, combined with oral/intravenous use of vitamin C, etc. Can effectively enhance the curative effect of chloasma. However, the use of the drug requires strict attention to contraindications.

          Therefore, clinical and related studies have proved that microneedling therapy can effectively promote the transdermal absorption of relevant functional ingredients, repair and rebuild the skin barrier and basement membrane band at the skin lesions of patients with melasma, and reduce pigmentation. It is an effective and safe method. And the melasma treatment method with stable curative effect, its single or combined application can significantly improve the melasma skin lesions, and there are few adverse reactions, we need to carefully experience in practice.