The selection of a 1.5 mm needle length is strictly dictated by the anatomical location of the pigment in refractory melasma. This specific depth allows the device to bypass the superficial epidermis and penetrate the mid-to-upper dermis, targeting deep-seated melanin that shorter needles simply cannot reach.
Refractory melasma is defined by pigment deposits located deep within the dermis. A 1.5 mm needle creates a controlled injury that disrupts these deposits and triggers skin remodeling, striking the necessary balance between aggressive treatment and safety.
Targeting the Root of the Problem
Reaching the Dermal Layer
In cases of refractory melasma, melanin is not limited to the surface; it is deposited deeply.
A 1.5 mm needle is required to physically reach the mid-to-upper layers of the dermis. Shallower needles typically fail to impact the melanocytes or melanin-laden macrophages responsible for the condition.
Triggering Skin Remodeling
The mechanical action of the needle does more than just reach the pigment; it induces a physiological response.
By creating a controlled moderate injury at this specific depth, the treatment triggers deep skin remodeling. This process facilitates significant pigment reduction and metabolism.
Promoting Collagen Induction
Beyond pigment disruption, penetrating the dermal layer produces sufficient stimulation to induce collagen remodeling.
This structural renewal supports the skin's ability to heal and regenerate, further assisting in the reduction of visible pigmentation.
The Mechanics of Precision
High-Density Coverage
Efficacy is not just about depth; it is about density.
Devices often utilize a 36-pin configuration to create high-density micro-pores. This increases the coverage rate of micro-injuries during reciprocating movements, improving overall treatment efficiency.
Material and Sharpness
The integrity of the needle affects the outcome of the injury.
Medical-grade stainless steel is typically used for its high hardness and biocompatibility. This prevents the needles from bending or breaking during the stress of skin penetration.
Understanding the Trade-offs
The Risk of Mechanical Tearing
While depth is necessary, the quality of the entry is critical to prevent worsening the condition.
If needles lack sharpness or structural integrity, they cause mechanical tearing rather than clean micro-channels. This can lead to significant thermal damage and trauma to surrounding tissues.
Preventing Post-Inflammatory Hyperpigmentation (PIH)
Melasma patients are highly susceptible to rebound pigmentation.
Precise, clean micro-channels minimize the inflammatory response. By reducing mechanical tearing, the risk of post-inflammatory hyperpigmentation (PIH) is significantly lowered, ensuring the treatment resolves the pigment rather than aggravating it.
Making the Right Choice for Your Goal
To treat refractory melasma effectively, you must prioritize depth and precision over superficial resurfacing.
- If your primary focus is effective pigment reduction: Ensure the device is set to 1.5 mm to physically reach the dermal melanin deposits that drive refractory melasma.
- If your primary focus is safety and PIH prevention: Verify that the device uses high-quality stainless steel needles to create clean channels and avoid mechanical tearing.
The 1.5 mm depth is the definitive standard for this condition because it is the only length that accesses the problem source without causing permanent scarring.
Summary Table:
| Feature | 1.5 mm Needle Treatment | Impact on Refractory Melasma |
|---|---|---|
| Target Depth | Mid-to-upper dermis | Reaches deep-seated melanin unreachable by shallow needles |
| Mechanism | Controlled mechanical injury | Triggers skin remodeling and pigment metabolism |
| Needle Quality | Medical-grade stainless steel | Ensures clean micro-channels and prevents mechanical tearing |
| Secondary Benefit | Collagen induction | Improves skin structure and supports regenerative healing |
| Safety Focus | High-density micro-pores | Minimizes inflammation to reduce the risk of PIH rebound |
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References
- Émerson Silva Lima. Microneedling in facial recalcitrant melasma: report of a series of 22 cases. DOI: 10.1590/abd1806-4841.20154748
This article is also based on technical information from Belislaser Knowledge Base .
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