A Systematic Review of the Efficacy and Safety of Microneedling in the Treatment of Melasma

Abstract

BACKGROUND Melasma is an acquired disorder of hyperpigmentation that is often recalcitrant to current therapies. Microneedling is used to treat scars, striae, and rhytides and has a relatively low risk of post-treatment dyspigmentation. Several studies have examined its use in melasma. OBJECTIVE To review the published evidence on the efficacy and safety of microneedling in the treatment of melasma. METHODS A systematic review was performed. A meta-analysis could not be performed because of methodological differences across studies and data heterogeneity. RESULTS Eight studies were included for analysis. Most studies assessed the utility of microneedling in combination with other topical therapies and detected some success. However, microneedling-mediated transdermal delivery of medications is not superior to microinjections of medications. There is less evidence supporting the use of microneedling as monotherapy. Microneedling, when used with a 1064-nm Q-switched Nd:YAG laser, may provide additional benefit, although with a risk of post-treatment dyspigmentation. CONCLUSION Based on low-quality evidence, microneedling may play a role in the treatment of melasma, with the mechanism of action likely being the facilitation of delivery of topical therapies to the epidermis and dermis, and one ancillary benefit of this approach being the very low risk of postinflammatory hyperpigmentation.

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“…[121][122][123][124] Newer non-pharmacological options include the use of microneedling and picosecond lasers. 125 All these treatments have shown positive results in their respective studies; however, stronger more robust studies and their efficacy and safety profile in skin of colour are still lacking. As such, additional research is required before possible recommendations can be made regarding their use.…”

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“…It is also worth emphasizing the role of microneedling, which when combined with active substances, e.g., tyrosinase inhibitors, TA, vitamin C, PRP seems to be an effective and safe additional and complementary treatment method, with a relatively low relapse rate, and can be used in daily medical practice [240][241][242].…”

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“… 121 – 124 Newer non-pharmacological options include the use of microneedling and picosecond lasers. 125 All these treatments have shown positive results in their respective studies; however, stronger more robust studies and their efficacy and safety profile in skin of colour are still lacking. As such, additional research is required before possible recommendations can be made regarding their use.…”