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Is Microneedling Contraindicated in Patients With Glycation?

posted in Adverse effects from microneedling, Topical ingredients combined with microneedling by

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Wrinkles may worsen with microneedling in patients prone to glycation, but this is not an absolute contraindication to treatment.  Glycation is due to abnormal cross-linking of collagen. Therefore, the more new collagen that is produced via needling, (be that cosmetic or medical), the more cross-linking, the worse the appearance, if it was truly due to glycation.  Patients should be aware of this and sign informed consent.

Glycation looks like ‘cobblestone’ which is quite different to loss of structural integrity due to sun damage.  In the latter, we typically also see hyperpigmentation.  Other things to consider that may ‘appear’ similar to glycation, or complicate the appearance of glycation, would be scarring (due to electrolysis or chemical peels, done repeatedly over a lengthy time), or sebaceous hyperplasia.  Solar elastosis may also have a similar appearance.  http://www.dermnetnz.org/dermal-infiltrative/solar-elastosis.html

Glycation is more pronounced in diabetics and influenced by diet, so any positive changes associated with needling may also be due to dietary advice given at the time of consultation.  Products that contain ingredients that combat glycation, such as L-Carnosine, or Supplamine, should always be used in conjunction with microneedling.  These can be applied topically or taken as a supplement.  I would recommend both oral and topical in severe cases.

Remember that a normal fasting blood sugar and HgbA1c does not rule out glycation. In the early stages of metabolic disorders the body may compensate to maintain normal readings, so the pathological process is occurring without evidence of the endpoint (abnormal blood test).  In other words, the body is “working” much harder to be “normal”.  Another point to consider is that readings may be set high at the lab for the benchmark for pathology so as not to have too many of the population labeled as diabetics.  If one believes in prevention rather than cure, we should not be waiting for full-blown endpoint pathology, such as nerve and skin damage via glycation, to establish itself.  Diet and exercise is considered a good place to start.

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25 Feb, 16

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There are 4 comments. on "Is Microneedling Contraindicated in Patients With Glycation?"

 

  • ***Amanda Hughes*** says: posted on 26 Feb, 2016

    So, if it’s a positive diagnosis of absolute glycation, microneedling is NOT advised?

    Reply
    • ***Dr. Lance Setterfield*** says: posted on 13 May, 2016

      Microneedling can still be performed if, and only if products and supplements are used containing ingredients that block the abnormal cross-linking of new collagen that characterizes glycation. Patients need to be warned in the informed consent that wrinkles may worsen despite using such products.

      Reply
  • ***Jodi*** says: posted on 21 Jun, 2016

    i had microneedling done 3 1/2 months ago and my skin is so much worse. Many crows feet around eyes that I didn’t have before, orange peel and wrinkles on forehead and large pores with tiny rips around moth area. Is there anything I can do now to make things better? Please help I’m very depressed over this.

    Reply
    • ***Dr. Lance Setterfield*** says: posted on 06 Jul, 2016

      Hi Jodi. Sorry to hear about your adverse outcome following needling. Having not seen you in person, I am unable to comment. There could be many reasons for your outcome and without knowing the underlying cause/s, it is impossible to offer solutions. The rule of thumb is “less is best”. People tend to do more aggressive treatments to try and fix things when they go wrong and end up making them worse. A good skin care product should be used to optimize skin health and although results tend to take a long time with creams or serums alone, TLC is what your skin needs most. Be sure to take good pictures every 4 months or so to document your progress because change will be so gradual and you won’t notice anything without photos.

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