Educational Series: Micro-Magic – Treating Pigmentation with Medical Microneedling

by | 1 November 2023

To begin this educational series on the subject of pigmentation & EXCEED Medical Microneedling, we need to understand what pigmentation is, and why it occurs in the skin, as well as the presentations of pigmentation versus what is and what isn’t treatable in the skin. We will then understanding the skin treatment modality of EXCEED Medical Microneedling, how it works, and the science behind how it can improve the appearance of pigmentation.

Let’s begin by understanding what is pigmentation… 

 

Presentations of Pigmentation

 

Pigment (melanin) is a protein that is produced by specialised cells in your skin called melanocytes, situated in the outermost layer called the Epidermis. These melanocytes play a primary role in the skin barrier defence systems and are programmed to create melanin. Pigmentation or an increase in melanin, occurs when the skin is exposed to direct UVR exposure or via the Retina of the eye. It can also occur due to hormonal imbalances in the body. 

An increase in pigmentation resembles brown localised spotted areas of discolouration, as the melanocyte is programmed to make more melanin than it was before. Melanocytes are very temperamental cells and when damaged, can cause a lifetime of problems. Let’s take a look at what these melanocytes look like on a cellular level…  

 

Treating Pigmentation with Medical Microneedling  

 

Melanocytes  

The melanocyte is the name of the cell that is responsible for the formation of melanin that colours our hair, skin and eyes. The pigment that is genetically programmed to be created includes a red pigment called “Pheomelanin” and/or brown pigment called “Eumelanin.” These pigments are manufactured in granules called, melanosomes (see image above). 

Every skin colour (Fitzpatrick) has approximately the same number of melanocytes. In fact, there are around 1,200 melanocytes per mm2! It doesn’t matter if you’re a lighter Fitzpatrick or a darker Fitzpatrick, we all have the same number of melanocytes. One melanocyte will have access to around 30-36 Keratinocytes (epidermal cells that up-take the melanosomes) to provide protection for the cell nucleus against UVR. 

Melanocytes are long-living, slow-cycling cells, and when impaired can cause a lifetime of problems. How do they become impaired?  

 

Causes of pigmentation  

Let’s take a look at some of the factors that can cause pigmentation in the skin; 

  1. Exposure to UV radiation via the skin and the retina of the eyes  
  2. Hormones (estrogen driven) 
  3. Injury, trauma & heat can cause an overproduction of melanin   
  4. Autoimmune conditions

It is absolutely essential to treat or manage as best you can the underlying causes and triggers of why pigmentation has occurred in the first place. For example, if your pigmentation is driven by too much sun exposure, you need to avoid being a sun bunny and invest in your skin by wearing a UPF 50+, sun hat, polarised sunglasses, and investing in a suncream product (we recommend dermaviduals SPF 15), as well as topical antioxidants such as vitamin C and E to neutralise the cellular damage that is being done to the melanocytes. 

 

Treating Pigmentation with Medical Microneedling  

 

Antioxidants go hand-in-hand with your suncream, as it prolongs the efficacy of your sun protection while neutralising free radicals caused by sun exposure and the skin’s own Endogenous (internal) Oxidative processes. When your melanocytes create melanin, it causes a lot of free radical damage; particularly if you produce more Pheomelanin (red pigment). Antioxidants are so vitally important, and they must not be neglected or forgotten about. 

 

So, what pigmentation is treatable?   

 

HYPER-PIGMENTATION (too much melanin) is treatable, however, if the damage has been left to compound over decades, the melanocytes will be past their prime due to suffering from Mitochondrial DNA damage and results will be limited. 

HYPO-PIGMENTATION (no melanin) cannot be treated, as the melanocytes are no longer producing melanin. 

Now that we understand pigmentation, what it is and how it occurs, let’s now explore the skin treatment modality of Medical Microneedling and how it operates in the skin to reduce the appearance of hyper-pigmentation.  

 

Treatment of pigmentation

Medical microneedling using the EXCEED device uses medical grade stainless steel needles to invoke a controlled wound healing response in the skin that results in the production of protein molecules (cytokines and growth factors) that work to encourage collagen production. However, did you know that medical microneedling has the ability to down-regulate the expression of an enzyme called, tyrosinase, as well as reducing a receptor in the skin called the MC1R (which plays a role in supporting the up-take of a hormone called the melanin-stimulating hormone (MSH). Yes, you guessed it, MSH controls melanin formation. 

 

Treating Pigmentation with Medical Microneedling  

 

Medical microneedling also releases anti-inflammatory cytokines that PROTECT melanocytes.  

Before we go any further, let’s explore what tyrosinase is so we have a sound understanding as to how medical microneedling can inhibit melanin formation in the skin.  

What is tyrosinase?  

Tyrosinase is an enzyme that is responsible for the manufacturing of the pigment-carrying melanosomes that contain melanin. Its function is to convert tyrosine (an amino acid) to a chemical compound called dopaquinone (dopa). Tyrosine is part of the building-block process of creating melanin, located inside the melanosomes. Tyrosinase will oxidise tyrosine to dopaquinone which undergoes actions leading to precursors of melanin pigments. 

Medical microneedling increases a growth factor called TGF-B1 which restricts pigment formation through down-regulation of tyrosinase via decreased gene expression. Microneedling also stimulates TGF-B3 which has anti-inflammatory effects within the skin, maintaining melanocyte balance and restoring the skin barrier.  

Medical microneedling down-regulates the MC1R gene (coding for the MSH), which results in decreased melanin production. Therefore, medical microneedling performed in isolation regulates and normalises melanin formation, both at a melanocyte and keratinocyte level. It does NOT cause hyper-pigmentation without other influencing factors. 

In summary, medical microneedling for the treatment of pigmentation corrects the following:  

  • Restores keratinocyte function, which normalises cell signalling with melanocytes  
  • Restores keratinocyte function, which optimises pigment uptake  
  • Restores overall skin structure and function for healthy and sustainable skin 

If you’re someone who is struggling with pigmentation, then a series of medical microneedling treatments with the EXCEED device could be part of the solution! Of course, it is not the only answer as there are a few steps that need to be undertaken prior to ensure that your skin is ready for medical microneedling. Let’s explore…  

 

Treating Pigmentation with Medical Microneedling  

Preparation Phase 1: Lead Up to Treatment Week 1 to 4

To achieve superior results in the lead up to having a microneedling treatment, your skin must be prepared for a minimum of four weeks using Corneotherapeutic skincare (cleanser, treatment tonic, DMS Base Cream, Suncream etc). Before introducing microneedling, the MTS Home Rolling System is to be introduced. This is to ensure the cells of the skin are supported. 

Click here to learn more about MTS Rolling. 

Homecare Phase 2: Week 5 to 6

The introduction of a custom serum containing ingredients to further support the skin and its condition along with essential vitamins such as A, B, C, E and Zinc is required to further prepare the skin for both cosmetic rolling and medical microneedling.  

Your skin treatment therapist will support you with this in order to ensure optimal results!  

Homecare Phase 3: Week 7 to 8

Continue the application of your prescribed dermaviduals homecare and introduce the MTS Home Rolling System (0.2-0.3mm) to support skin rejuvenation. Your skin treatment therapist will guide you on how to use your MTS Home Rolling System.  

The application of a DMS Base Cream and/or Oleogel Plus can be applied post cosmetic rolling, and it is best practice to perform your treatment of an evening and continue with your prescribed dermaviduals homecare the next day. 

Homecare Phase 4: Week 9 to 10

Repeat Homecare Phase 3. 

EXCEED Clinical Treatment: Week 11 to 12

You are now ready to experience your first EXCEED Medical Microneedling treatment! Your skin treatment therapist will guide you through what is required prior and post your EXCEED treatment to ensure optimal and sustainable results for your skin! 

If you would like to learn more about what EXCEED and dermaviduals can do for your skin, we recommend reaching out to a Practising Corneotherapist who is well-versed in the use of dermaviduals products. They can provide you with personalised information and guidance based on your specific skin type, concerns, and goals. A Practising Corneotherapist can assess your skin’s unique needs and suggest appropriate EXCEED and dermaviduals products or treatments that may benefit you, especially if you are concerned with the skin condition pigmentation. 

 

To locate your nearest EXCEED clinic, use our clinic finder. 

 

Written by Kai Atkinson