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Needling in vitiligo

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Needling is a simple surgical procedure which aids in the repigmentation of vitiligo lesions. 

 

The technique involves passing a 30G needle repeatedly along the edge of vitiligo lesions to allow for the transfer of melanocytes from the pigmented borders to the depigmented parts of the vitiligo lesions.

There are several possible mechanisms of repigmentation with this technique:

 

  1. The hollow bore of the needle may cut through a core of tissue and transplant this core to the depigmented part of the vitiligo lesion when the needle is advanced. This may be likened a form of horizontal punch grafting.

  2. Channels may be created from the pigmented to the depigmented side through which melanocytes may physically migrate.

  3. The physical action of needling may cause the release of growth factors which could stimulate repigmentation.

  4. The melanocytes may be physically pushed from the the pigmented border to the depigmented vitiligo skin. 

 

Needling is often combined with excimer laser/light or narrow band UVB.

Repigmentation with UV light alone results in marginal or perfollicular repigmentation and the shape of the repigmented areas often have a rounded configuration.

© 2022 Dr N Raboobee

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