Can Microneedling Cause Hyperpigmentation
The idea of rolling hundreds of tiny needles all over your face in hope of better skin sounds like a recipe for disaster in the wrong hands… Especially for those with brown skin like myself. That’s mainly because Our skin tends to show signs of trauma more easily… like scars and dark spots. Dermatologists often used this to help treat texture and appearance issues with skin.
Can Micro Needling cause Hyperpigmentation? Is microneedling safe for dark skin?
Because micro-needling creates small punctures in the skin, I’m not a fan when It comes to clients with highly melanated skin. I do understand that it’s supposed to create a way that allows the skin to remodel on its own… However, because most of my clients have brown skin, I’ve seen too often the damage microneedling has caused them – They usually come to me, to help fix the damage from the micro-needling treatments
Does microneedling even skin tone?
One of the main things I’ve seen with microneedling is that the punctures caused by the device can cause darkening of the skin. Oftentimes, the person doing it goes a bit deeper than they should have. As a result the depth of the needles penetrate and hit the dermis – in some cases, you want that if you want to stimulate the collagen… Those with brown skin, when your skin feels like it’s under attack all it wants to do is protect you, it starts to produce an excessive amount of pigment- causing the area to become darker. Although the needles are so tiny that they should not cause trauma to the skin… I’ve seen a lot of cases when that wasn’t the case…
What most people wish they knew before They tried micro-needling is this
Microneedling is not a service you want to “Just Walk-in to”. There should be prep work and post-procedure care… That’s the only true way to get optimal results. Most professionals start their clients with some hydroquinone, retinoid, Sun protection, and at times a topical steroid. It takes more than one treatment, you have to follow up with consistent home care paired with professional treatments… Most importantly, Not all who provide this service are properly trained to do it.
Is Microneedling a safe skin treatment for ethnic and darker skin?
For those with darker skin, laser treatments, micro-needling, and many other forms of skin-renewing/rejuvenating treatments – additional problems can arise. When trauma and excessive heat(laser treatments for example are applied to darker, ethnic skin, it can result in pigmentation problems – the thing you’re trying to treat. At times, the damage can be permanent. While micro-needling can help in some cases… it could also turn into a nightmare if you’re not careful.
Is micro needling effective with all skin types
On average, your skin weighs about 21 pounds. Your skin is the largest organ of the body. Although many people don’t think about the daily functions of the skin.. Your skin is your body’s first defense – keeping many things ( including bacteria and germs) from entering the body. Oftentimes, when you hear people talking about “what’s your skin type… they are referring to where you fall on the Fitzpatrick Skin Type Scale – this also tells us how your skin reacts to sun exposure… for example, Do you tan and/or burn easily?
Not all treatments were created equally… Do your research to find a specialist because… burns, scarring, and pigmentation issues can happen. If you’re not careful… it could become permanent. Make sure you are choosing a qualified professional.
Can You experience dark spots after microneedling
In this guide, we find out the following: Can Microneedling Cause Hyperpigmentation, microneedling post inflammatory hyperpigmentation, How can I prevent pigmentation after microneedling, Why does my skin look worse after microneedling?
Can Microneedling Cause Hyperpigmentation
One of the most common questions I get asked about microneedling is, “Does it cause hyperpigmentation?” And my answer is usually no. Microneedling can cause hyperpigmentation, but this is rare when performed by a professional.
What Is Hyperpigmentation?
You may have heard the term hyperpigmentation thrown around before without really knowing what it means. In this article, we’ll be talking about what hyperpigmentation is, how it occurs and what causes it.
Hyperpigmentation is a condition in which dark spots appear on your skin. These spots can range from light brown to black and are caused by an overproduction of melanin, which gives your skin its color. Hyperpigmentation can occur anywhere on your body but is most noticeable on areas with thinned or damaged skin like cheeks or lips (1).
How Does Hyperpigmentation Happen?
There are two types of hyperpigmentation: postinflammatory pigmentation and solar elastosis (2). Postinflammatory pigmentation results from inflammation or irritation in the epidermis (outermost layer) of the skin; this causes melanocytes (cells that produce melanin) to become overactive and produce excess pigment (3). Solar elastosis refers specifically to dark patches caused by sun damage; this type tends toward being larger than postinflammatory patches because there’s no initial injury involved–it just happens over time as a result of exposure to UV rays
Can Microneedling Cause Hyperpigmentation?
Yes, it’s possible to cause hyperpigmentation from microneedling. But this is not something that happens often and is usually due to too much trauma to the skin during treatment or improper aftercare.
If you have any concerns about getting a procedure done by your dermatologist or esthetician, speak up! They will be able to address your concerns and make sure that you are comfortable with what they are doing before moving forward with your treatment plan.
If Microneedling Does Not Cause Hyperpigmentation, What Does Cause It?
- Sun exposure: This is the most common cause of hyperpigmentation, and it’s not just because you’re getting sunburned. Ultraviolet rays from the sun can penetrate deep into your skin and cause damage that lasts for years. The result is dark spots on your face and body that are difficult to get rid of no matter what products you use or how much money you spend on laser treatments.
- Smoking: Tobacco smoke causes oxidative damage in the body, which can lead to premature aging and discoloration of your skin (1). If you smoke heavily or have been exposed to secondhand smoke at any point in time during adulthood (even if it was just once), then there’s a chance this has caused some permanent discoloration in addition to other health problems like emphysema or lung cancer
How Do You Prevent Hyperpigmentation From Microneedling?
When you’re getting microneedling, it’s important to be vigilant about sun protection. Sun exposure is one of the biggest causes of hyperpigmentation, so make sure you use SPF 30 or higher every single day on any areas that have been treated with microneedling.
In addition to using sunscreen, it’s also helpful to invest in a good moisturizer that contains hyaluronic acid (HA), which attracts water molecules from the environment and locks them into skin cells so they can’t escape as easily–this helps keep your skin hydrated and plump-looking. A topical retinoid like tretinoin or isotretinoin (better known as Accutane) has been shown to prevent hyperpigmentation by increasing cell turnover rates so dead skin cells shed faster than usual; this means less time for melanocytes (cells responsible for producing melanin) to produce more pigment than normal before they’re shed away from their spot on your face!
If all else fails and your face still ends up looking like an oil slick after getting microneedled, there are other options: prescription creams containing hydroquinone work well at preventing dark spots from forming; topical vitamin C serums contain antioxidants that prevent free radicals from damaging healthy cells; and even plain old aspirin can help reduce inflammation around these areas by thinning out blood vessels below the surface level where they aren’t supposed
Microneedling can cause hyperpigmentation but it is rare when performed by a professional.
The most common cause of hyperpigmentation is sun damage. The second most common cause is acne. Other factors that can cause hyperpigmentation include genetics and hormones, but these are less likely to be an issue for people who have been microneedling done by a professional.
If you notice that your skin has become darker following a microneedling session, it’s possible that the procedure caused some damage within the layers of your skin and triggered an inflammatory response from your body. You should see a dermatologist immediately if this happens so they can determine whether or not it’s something serious (or even treatable).
microneedling post inflammatory hyperpigmentation
Microneedling is a professional treatment for a number of skin concerns such as skin rejuvenation, acne scars, enlarged pores and melasma. Hyperpigmentation refers to dark spots or pigmented patches of skin that develop due to a variety of factors. With microneedling, hyperpigmentation can be effectively treated by breaking up the pigment beneath the skin’s surface.
How Can Microneedling Treat Hyperpigmentation?
Hyperpigmentation refers to spots or patches of skin that are darker than the surrounding area. They develop due to several factors including sun exposure, hormonal fluctuations, inflammation, and with age.
Melanocytes within skin cells produce melanin which is responsible for providing skin its color. When overproduction occurs, excess melanin accumulates and forms hyperpigmented patches.
Microneedling involves piercing the skin with small sterile needles to produce a controlled skin injury. This triggers the skin’s wound-healing process which prompts skin cell turnover and allows fresh, new cells to replace damaged ones. At the same time, it boosts collagen and elastin production to remodel skin by altering tissue formation.
Does it Work?
Although there are a paucity of studies examining microneedling and hyperpigmentation, it has been determined to be a viable treatment for several reasons. In addition to showing promise as a skin-lightening solution, it is well-tolerated among all skin tones, including skin of color.
Additionally, it has been studied as one part of combination therapy that includes transdermal drug delivery. This involves microneedling the skin and then applying a topical medication to allow for better absorption to achieve better results.
These results were clearly demonstrated in one study on melasma, a difficult-to-treat pigment disorder. Researchers examined patients treated with combined skin needling and depigmenting serum on one side of the face versus depigmenting serum alone. The side with combined treatment was significantly improved compared to the single treatment.
How many sessions you will need will depend on your skin concern and its severity. As an example, 3–6 sessions may be effective to treat hyperpigmentation; for melasma, 2 sessions have been demonstrated to decrease pigmentation and increase collagen levels.
Melasma
Melasma is a chronic skin disorder that causes brown or gray-brown patches of discolored skin. It is notoriously difficult to treat, and follows a sequence of relapse and repeat, however there is strong evidence supporting microneedling as an effective treatment for this condition
In one small study that administered 2 sessions of microneedling, patients reported 100% satisfaction with their results. One conclusion researchers reached was that microneedling used without the addition of topical solutions can effectively lighten the skin of patients with melasma.
For the most part, microneedling is used as an adjuvant to increase the efficacy of other agents.
In a review of studies that combined microneedling with other topical treatments such a tranexamic acid, vitamin C, nonhydroquinone and hydroquinone-based depigmenting agents, the combination therapy provided greater results than topical therapy alone.
Periorbital hyperpigmentation
Periorbital hyperpigmentation, also known as periocular hyperpigmentation, refers to dark circles under the eyes. It is a very common skin condition that is considered to be genetically based.
Microneedling as adjunct therapy has also been proven to be effective in treating this type of hyperpigmentation. One study combined trichloroacetic acid (TCA) peels with microneedling to achieve significant improvements.
Another study divided treatment into phenylethyl resorcinol (a skin-whitening agent) with microneedling and phenylethyl resorcinol alone. The skin-whitening gel achieved significant improvement in depigmenting skin but the combined therapy provided greater results.
Microneedling under the eye can also reduce hyperpigmentation by adding lost volume through increased collagen. Typically 4–6 sessions are required to achieve the best results.
Postinflammatory hyperpigmented scars
Hyperpigmented scars typically result due to a skin injury such as burns, cuts, skin infections and skin conditions such as acne. These scars are referred to as postinflammatory hyperpigmentation (PIH), and can form once an injury or inflammation has healed, leaving dark pigmented marks in its place.
Microneedling to treat hyperpigmented scars works the same way as for any forms of hyperpigmentation – by prompting skin cell turnover and stimulating collagen production to smooth skin texture and lighten tone. The number of treatments will depend on the amount of scars and their severity; typically 3–6 sessions.
Sunspots
Liver spots, sunspots or solar lentigines refer to flat brown spots that develop on skin due to overexposure to UV light. Microneedling can provide greater delivery of skin lightening serums through the layers of skin to regenerate the skin. Fresh, undamaged skin cells replace dark patches, and collagen formation allows for healthier, firmer skin.
Hyperpigmentation Before and After Microneedling
Side Effects of Microneedling for Hyperpigmentation
Microneedling is a noninvasive procedure and is therefore associated with mild side effects; serious side effects are rare.
Can microneedling make hyperpigmentation worse?
Microneedling can cause hyperpigmentation to worsen but it is difficult to discern the cause as there are so many variables involved: sun exposure, skin type and tone, genetics, environmental factors, hormones, skin care products, etc.
As this procedure inflicts controlled damage to the skin some inflammation will occur, and this is a wanted and expected part of the treatment. However, sometimes this inflammation leads to worsening hyperpigmentation— especially for people of color—as they have higher levels of pigment in their skin.
How can I prevent pigmentation after microneedling
The question as to whether hyperpigmentation occurs due to microneedling is brought up repeatedly. The obvious question is that if “post-inflammatory hyperpigmentation” (PIH) is common in darker skin types, why would needling not be considered “high risk” in these patients, given that inflammation results with needling? The answer hinges around the degree and duration of inflammation. This response is typically not prolonged, nor is it as intense after needling when compared to other treatment modalities. Microneedling stimulates production of TGF-B3 which has anti-inflammatory effects. It also stimulates TGF-B1 which restricts pigment formation through downregulation of tyrosinase via decreased gene expression as well as decreasing its intracellular half-life. [i] Also, anti-inflammatory skincare ingredients, such as phosphatidylcholine, typically used in conjunction with needling, limit the inflammatory response. There are other mechanisms due to microneedling that normalize pigment formation as well which I won’t discuss here.
The problem with hyperpigmentation is that there are so many variables and it is almost impossible to determine underlying cause with complete certainty. It usually involves multiple factors. Yes, there are the typical causes which we tend to focus on, such as sun exposure, PIH, smoking, genetics, hormones, photosensitizing meds and skin care products, etc., but the list is too extensive to include here, though some lesser known causes are discussed below.
Microneedling is touted as being colorblind, though it is the microneedling PLUS…..and you can fill in the blanks with chemical peels, photosensitizers, sun exposure, etc. that results in hyperpigmentation. Microneedling is never done in isolation. Life happens. Avoiding sun exposure is virtually impossible in the weeks following treatment. Women have hormones that influence melanogenesis. Many people are on medications which cannot be discontinued that are photosensitizers. Higher Fitz patients are exceptionally capable of producing pigment, and once we have awakened the sleeping giant with rejuvenation treatments, all the traditional treatments for pigmentation, such as IPL, Laser, and Chemical Peels, provoke a perturbed cell even more.
In summary, Microneedling in isolation regulates and normalizes pigment formation, both at a melanocyte and keratinocyte level. It does not cause hyperpigmentation without other influencing factors.
Here are some additional lesser-known things to ponder:
For those of you who have completed my Online Course and attended my live class, you will recall that light stimulation of the pituitary gland via the retina can increase MSH (Melanin Stimulating Hormone), so pigment can increase while indoors looking at a computer screen all day.
A lesser-known cause of hyperpigmentation pertains to temperature. If you were to treat someone who lived in a hot climate, but hypothetically lived in the dark (a vampire for instance), they could still develop hyperpigmentation. This mechanism is poorly understood. One theory is that increased perfusion drives the melanogenesis equation to production via an abundance of precursors for melanin, though I have not found any studies to verify this. However, increased temperature does accelerate the tyrosinase reaction and is thought to explain hyperpigmentation found in skin chronically exposed to heat sources and body folds. [ii]
There is also a condition called “erythema ab igne”, where pigmentation results due to angiogenesis caused by heat exposure, e.g. hot water bottle, laptop, ovens, etc. It is thought that chronic vasodilatation from heat leads to leaking of inflammatory cells into the tissue with ensuing post-inflammatory hyperpigmentation.
As a side note, pH also affects melanogenesis. One study showed that melanin synthesis is maximal at a pH of 6.8 and melanin production is suppressed by lowering melanosome pH. [iii] Conventional wisdom maintains that the chief mechanism of action with most chemical peels is through exfoliation, but there may well be other mechanisms that play a greater role than we think. Not that I want to encourage you to rush to this treatment modality as a first choice in treating hyperpigmentation because exfoliating the natural barrier, along with the bilayers, has its own drawbacks that complicate the cascades of wound healing triggered by microneedling. Chemical peels, by definition, cause inflammation. This adds fuel to the fire in patients at high risk for post-inflammatory hyperpigmentation. Due to the power of Microneedling pens compared with rollers, it is easier to over-treat the skin with electronic devices, especially when some recommend bleeding and maceration as the endpoint. This inevitably also creates significant inflammation, and thus combining chemical peels with microneedling increases the risk of PIH considerably in high Fitz patients.
In essence, microneedling is a proven treatment for optimizing skin health that is superior in many ways to other treatment modalities, but, like most things in life, it has its limitations. In our quest for maximizing results beyond these limitations we often try to amplify the positive effects by adding other treatment modalities, forgetting that microneedling may also amplify the negative effects of these treatments through increased absorption or inflammation. Frequently these problems arise when pushing the envelope while trying to compete with practitioners that have greater scope of practice in an attempt to equal their results. A good example of this is when aestheticians use a cosmetic roller and occlusion to enhance penetration of topical anesthetic, thus converting an OTC product into a “drug” that would normally require a prescription to attain those levels of effectiveness. This defeats the purpose of imposing dose level restrictions and removes the very protection it was supposed to afford the practitioner (and client/patient) according to their level of ability and responsibility should an emergency occur, such as cardiac arrest.
Why does my skin look worse after microneedling?
Microneedling is a procedure where the skin is microscopically pierced thousands of times over a very short period of time. These tiny holes are essentially ‘micro-wounds’ which cause a reaction from the body to trigger the natural healing process. This process has many beneficial impacts on skin health, such as new collagen and elastic synthesis, as well as new blood vessels within the dermis. However, your skin can appear unsightly immediately after the procedure.
Microneedling is a fairly common aesthetic procedure nowadays, with most offices that offer botox, facial peels, or dermaplaning also offering microneedling. It is popular due to its wide range of uses such as anti-ageing (by diminishing wrinkles and fine lines) and reducing the impact of acne (by helping to reduce scarring texture.)
So, what actually happens at a microneedling appointment? First, your skin will be cleansed and if appropriate, numbed. This is usually done using a cream, which helps to reduce any pain felt during the procedure. The microneedling device is then passed across the skin, in the affected areas. Once all areas are treated, your face is cleansed again.
Common Misconceptions of Microneedling
Microneedling is painful – as the needles are very small, they can barely be felt! However, if you are sensitive to pain, a numbing cream before the procedure is a common choice.
Needles? Won’t that cause bleeding? – microneedling rarely causes bleeding, it’s unlikely to happen with shallow microneedling, whereas deeper microneedling it is more likely to occur. Even if this does occur, it’s often a small amount and well managed by the practitioner. It’s important to note this may not be a suitable treatment if you are on blood thinning medication, so always disclose this information.
Won’t the punctures cause scarring, or discoloration? – For any sort of scarring or discoloration to occur, the dermis must be damaged. This is the deepest level of the skin, meaning it won’t be touched by the needle machine used! This means it will only work on previous scarring, without creating any new ones.
Microneedling will give me an infection – microneedling has very low risks for infection, especially as the needles are sterilized before treatment, and the skin is cleansed.
Common Side Effects of Microneedling
As with any procedure there are multiple side effects, with some of the most common outlined below:
This happens because the top layer of the skin has been damaged, meaning there are thousands of tiny holes. This means the sun’s impact is greater than usual, so protecting your skin is even more important! For the first few days after the procedure, sun exposure should be completely avoided – so grab your duvet, and cozy clothes so you can binge watch the latest programme indoors! After this initial period, repeated application of sunscreen is important.
Redness or swelling of skin
Microneedling causes a low level of inflammation, meaning swelling and redness is quite a common side effect of microneedling. This will naturally decrease with time. However, if it doesn’t decrease it’s important to get your local health provider to check out all causes, as rarely microneedling can lead to rosacea or granulomatous dermatoses (which often look like small lumps on the skin) – occurring when an underlying infection inflames tissues.
Breaking out, aka active breakouts occuring
This is much more likely to happen if you already have acne-prone skin, or already active breakouts. This is because bacteria associated with acne will get in contact with the microneedle, and the needle will then push the bacteria further into the skin. This then causes more pimples, and often more severe inflammation. This means it’s kind of counterintuitive if you are treating your acne scars with microneedling before your acne is completely inactive – you’ll just end up creating more acne, and more scars!
Skin looks worse – fine lines and wrinkles look more pronounced
In your skin there is a chemical molecule called fibronectin, which acts as scaffolding for the new collagen to grow onto. Over time the collagen will mature, and be converted into a more tightened-up version. This version makes the wrinkles and scarring look reduced. By puncturing the skin hundreds of times with the microneedling device, the collagen fibers will be ripped, and then will take time to reform. That’s why in the short term wrinkles may appear worse off!
Another factor that impacts this is an increase in a process known as TransEpidermal Water Loss (TEWL) which essentially is the loss of water from the skin. More TEWL means the skin is more dehydrated, and skin will always show fine lines and texture more when dehydrated.
Microneedling vs. Chemical Peel
Both of these treatments are touted as being some of the best for acne-prone skin (Especially with scars) as well as for diminishing fine lines. However, if you’re unsure which to choose, hopefully this short guide will help you choose! If you really aren’t sure though, ring up your local esthetician and they’ll give you some advice – they truly are the professionals!
Chemical peels, when performed by an esthetician or dermatologist will be formulated with a higher percentage of acids than you would find in a serum you can use at home. The higher the percentage of acids, the deeper down the skin layers it can usually penetrate. This means deeper rooted scars, wrinkles and severe acne nodules can be treated in this way. Chemical peels contain many acids you are likely to have heard about, they’re listed below with their impact:
Your individual skin health will be assessed, so the chemical peel depth can be chosen correctly; there are usually three depths to choose from; superficial, medium or deep. The deeper the peel the greater the pain (local anesthetic, similar to the one used for microneedling is used) downtime, but also the impact is greater.
These two methods to improve skin health act in fundamentally different ways – whilst the microneedling causes low level damage to the skin, to encourage it to heal itself and thus produce new collagen to plump up any atrophic scars, the chemical peel causes the top layers of the skin to slough off (taking hyperpigmentation and congestion with it) and reveal healthier, more even-toned skin.
Any in-office treatment, performed by an accredited professional is likely to have a high price tag, which whilst warranted (do your research – don’t just trust your skin health with anyone!) may not suit everyone’s financial situation. Turning to at-home treatments may be more appropriate, and we have reviewed our favorite peels for acne scarring here.
Skincare Products to Avoid After Microneedling
Different organizations will state slightly different post-micro needling regiments, in terms of the skincare you should and shouldn’t use. As previously mentioned, the sun should be avoided entirely for at least the first 2-3 days, and then adequate sunscreen should be applied everyday from this point. It’s especially important, as your skin is extra sensitive to the sun, meaning damage is much more likely to occur (even if its cloudy).
Due to this sensitivity, any active ingredients in your usual skincare routine should be paused, so any acid exfoliants, retinols, prescription-only treatments, and vitamin C should be shelved for at least 3 days (but I personally would avoid for at least a week!)
A post-treatment routine is likely to consist of three things; gentle cleanser, (focus on hydrating and ceramides) an antibiotic cream and a very basic moisturizer/balm.
Although not skincare, it’s important to also avoid applying any makeup to the skin for a few days after the procedure. This is because any makeup will clog pores, and the micro-wounds created – which will trigger congestion and pimples. Also, most peoples makeup brushes and sponges aren’t fully clean, meaning there is old makeup and bacteria thriving on them – gross, but true. So by applying makeup to the skin, via dirty makeup tools, puts all the bacteria and grime onto the skin and can cause infections.
How to Improve Skin If It Looks Worse After Microneedling
Most of the time when skin looks worse after microneedling it is just a short term reaction to the procedure, and being patient really does wonders! Don’t be tempted by some of your usual skincare products, which help smooth or plump skin. Let the procedure work, and trust in the science of your skin repairing. Make sure to keep hydrated (especially as TEWL increases post-procedure) and limit intake of caffeine and alcohol, as they dehydrate both the body and skin. The eBook has some brilliant information about nutrition which may help.