Press Room

Have you ever been troubled by melasma? 

Melasma, a common skin pigmentation condition, is known as the ‘king of spots’. It is particularly prevalent in East and Southeast Asian countries, affecting women of childbearing age and pregnant women in particular. While melasma itself is not life-threatening, it affects the quality of life, mental health and social interactions of millions of women.

There are a variety of treatments for melasma, including traditional topical and oral medications. However, there is currently no specific treatment for melasma. So why is melasma known as the ‘king of spots’? Melasma can be caused by a number of factors, including genetics, exposure to ultraviolet radiation, hormonal changes, and the side effects of certain medications. However, the the most fundamental answer lies in its pathogenesis: photoaging. The main manifestations of ‘photoaging’ are tanning, ageing and redness.

In 2017, a major paper was widely recognised by the cosmetic dermatology community. This paper concluded that melasma is a photoaging disease.

During the development of melasma, photoaging damages the basement membrane zone. Large amounts of melanin, produced by epidermal melanocytes, fall through the gaps in the damaged zone into the dermis where they are consumed by macrophages to form melanophages. Melasma is therefore divided into two types: “epidermal”, where pigmentation occurs only in the epidermis and “mixed”, where pigmentation is evenly distributed in both the epidermis and dermis. To illustrate this, imagine a long-sleeved shirt with a hole in it. After being exposed to sunlight, the skin around the hole will develop a different colour.

Rather than saying that melasma is difficult to treat, it is more accurate to say that there are few ways to remove pigmentation from the dermis.

In recent years, scientists have made significant progress in understanding the causes of melasma and developing effective treatments. New treatments such as laser therapy and meso needle treatment(dermaroller) have demonstrated promising results in clinical practice. Meso needle treatment(or dermaroller) is an effective treatment for melasma for two key reasons:

1. collagen remodelling (repairing damage).
2. Transdermal absorption (delivering active ingredients).

Firstly, meso needle treatment(dermaroller) can be used to repair the basement membrane zone, much like mending a hole in clothing. Secondly, it delivers various anti-inflammatory, antioxidant and skin-lightening ingredients by penetrating the skin. These ingredients act on the dermis, contributing to the fading of melasma. Key ingredients include mussel mucin, tranexamic acid, PDRN, glutathione and vitamin C.

So, what length of meso needle (dermaroller) should you choose for treating melasma? Let’s review the fundamentals to select the most suitable needle length.

As we can see, an injury to the skin measuring 0.5 mm is considered mild, and a meso needle (dermaroller) of the same size can be used to deliver active ingredients. But what about repairing the basement membrane zone? The average thickness of the epidermis is 200 μm (0.2 mm), meaning the basement membrane zone is approximately 200 μm deep. In theory, targeting this depth would be more likely to repair the basement membrane zone. A gold microneedle device produced by a Korean company for the specific treatment of melasma by repairing the basement membrane zone has an effective depth of 300 µm (0.3 mm). This depth is appropriate as the damage is close to the basement membrane zone.

The recommended length is 0.3–0.5 mm for the following reasons:

1) Due to the resistance of ageing skin, a 0.5 mm meso needle (dermaroller) penetrates to a depth of approximately 70% of its length, or about 0.35 mm.

2) Longer meso needle (dermaroller) cause greater skin damage. This has two negative consequences. Firstly, trauma can cause physical inflammation, and the greater the damage, the more severe the inflammation. Secondly, greater damage increases damage to the epidermal skin barrier. Melasma is associated with inflammation and impaired skin barrier function. Therefore, we must minimise these negative effects.

3) A penetration depth of 0.5 mm places it close to the basement membrane zone, increasing the potential for repair through damage-repair mechanisms.

By the way, you can purchase roller needles directly with a length of 0.3–0.5 mm, but the shortest common meso needle is 1.5 mm. While it can be used to combat the signs of ageing, it is recommended that it is performed by a professional doctor or someone with extensive experience in cosmetic injections. And the recommended treatment schedule is once every four weeks. 

Finally, about nursing. It is important to understand that melasma is generally considered a chronic condition that may not be completely curable. However, with proper treatment and preventive measures, symptoms can be effectively managed and the progression of the disease slowed. So, how can you care for yourself effectively after treatment?

Sun protection is paramount, so avoid prolonged exposure to strong sunlight and wear a high-factor sunscreen. Also, wear a wide-brimmed hat and sunglasses outdoors. Maintain a balanced diet that includes foods rich in vitamin C and antioxidants, such as fresh fruit and vegetables. Avoid smoking and limit your alcohol intake, as these habits may exacerbate hyperpigmentation. For daily skincare, use gentle cleansers and moisturisers, and avoid cosmetics that may irritate the skin. Individuals with a family history of skin irritation should have regular skin examinations to detect potential problems early.