When is microneedling recommended for melasma?

Melasma causes brown or grey-brown patches, often on the face, and can become darker after ultraviolet or visible light exposure and skin irritation. Microneedling makes controlled openings in the skin and may help selected topical treatments reach the upper skin layers, but inflammation can also deepen pigmentation in some people. A clinician therefore considers skin tone, the pattern and activity of the melasma, current products, pregnancy or breastfeeding, and any history of dark marks after irritation. It is not usually the first step for unstable or recently worsening pigment.

Have the diagnosis confirmed before scheduling a procedure, because other pigment conditions can resemble melasma. Discuss a gentle skincare routine, pigment-directed treatment, and broad-spectrum sun and visible-light protection. Do not introduce strong exfoliants or irritating products without guidance. After treatment, use the recommended cleanser and moisturiser, avoid rubbing the skin, and protect it consistently while redness settles. See [Melasma](/conditions/melasma/) and [Microneedling](/treatments/aesthetic-procedures/microneedling/) for related information.

Delay treatment if the skin is sunburned, inflamed, infected, peeling, or reacting to a product. Contact the clinician if burning, swelling, crusting, blistering, or darkening is increasing after the procedure. New, one-sided, rapidly changing, bleeding, or symptomatic pigmentation needs an examination rather than cosmetic treatment.

Ask how active your melasma appears, whether microneedling could trigger more pigment in your skin, which treatment should be stabilised first, and how you will protect the result from light exposure. Ask what symptoms should prompt a review.