Microneedling as an Adjuvant to Topical Therapies for Melasma Journal of the American Academy of Dermatology

TAKE-HOME MESSAGE

• In this meta-analysis of 12 studies including 459 patients with melasma, the authors compared topical therapy alone and topical therapy with microneedling. Topical therapy with microneedling resulted in a substantially greater improvement in the Melasma Severity Index at 8 and 12 weeks compared with topical therapy alone. There were no serious adverse events reported. The heterogeneity of study designs did not allow for comparison between topical treatment modalities.

• Topical therapy with microneedling was more effective at treating melasma than topical therapy alone.

–  Kelly B. Scarberry, MD

Abstract 

BACKGROUND

Microneedling as an adjuvant to topical medications has shown promising but variable results in the treatment of melasma.

OBJECTIVE

To conduct a systematic review and meta-analysis on the efficacy of topical therapy with microneedling in the treatment of melasma.

METHODS

This study followed PRISMA guidelines. All comparative, prospective studies on the use of topical interventions with microneedling for the treatment of melasma were included. Studies involving radiofrequency microneedling were excluded.

RESULTS

Twelve eligible studies comprising 459 patients from seven different countries were included. Topical therapies included topical tranexamic acid, vitamin C, platelet rich plasma, non-hydroquinone-based depigmentation serums, and hydroquinone-based depigmenting agents. Topical therapy with microneedling improved melasma severity with a large effect (SMD>0.8) beyond 8 weeks, with best results seen at 12 weeks. Compared to topical therapy alone, topical therapy with microneedling resulted in an additional improvement in melasma severity with a moderate effect at 8 weeks and a large effect at 12-16 weeks. Microneedling was well-tolerated across studies, with no serious adverse events reported.

LIMITATIONS

Heterogeneity in study design did not allow for a comparison of the efficacy of various topical therapies with microneedling.

CONCLUSION

Microneedling is a safe and effective adjuvant to topical therapies in melasma.

Journal of the American Academy of Dermatology

Microneedling as an Adjuvant to Topical Therapies for Melasma: A Systematic Review and Meta-Analysis

J Am Acad Dermatol 2021 Apr 12;[EPub Ahead of Print], AJ Michel Bailey, H Oi-Yee Li, MG Tan, W Cheng, JS Dover

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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