Assessment of the effects of skin microneedling as adjuvant therapy for facial melasma: a pilot study

Abstract

BackgroundMelasma is a common chronic and relapsing acquired dyschromia. Skin microneedling was reported resulting sustained long-term improvement of recalcitrant melasma, however, the exact mechanism that promotes this skin lightening is not known. This study aimed to investigate clinical and histologic alterations promoted by skin microneedling in facial melasma.MethodsOpen pilot trial including six women with facial refractory melasma submitted to two sessions of microneedling (1.5 mm) each 30 days followed by daily triple combination and broad-spectrum sunscreen. Comparison of pretreatment (T0) and 15 days after last microneedling procedure (T45) was made by standardized pictures, skin colorimetry, MASI, MELASQoL and histological parameters (haematoxylin-eosin, picrosirius-red, periodic acid Schiff and Fontana-Masson staining).ResultsThe age of the subjects varied from 34 to 46 years-old, the phototypes were III and IV (Fitzpatrick), and age of melasma onset was 20 to 38 years. Improvement of melasma was perceived in all subjects. There was a significant reduction of MASI score (−70%), MELASQoL (−55%) and increase in L* (+13%) colorimetric value (p < 0.03). All cases evidenced epithelium thickening, decrease in melanin pigmentation and densification of upper dermis collagen (p = 0.03). Patients were followed by 6 months under broad-spectrum sunscreen and triple combination without relapse.ConclusionIn addition to classic treatment (broad-spectrum sunscreen and triple combination), skin microneedling promoted clinical and histological improvement of refractory facial melasma.

Study of efficacy of microneedling and mesoneedling in the treatment of epidermal melasma: A pilot trial

“…In an open trial, Lima et al reported a significant reduction of MASI score from 37.1 to 11.0 (70% mean decrease in MASI) after two sessions of microneedling.…”

“…This produces small holes known as micro‐conduits, with minimal damage to the epidermis, allowing migration of epithelial and endothelial cells. The procedure has been shown to promote growth factor release and thus stimulate fibroblast proliferation, while also enhancing collagen and elastin production in the papillary layer of the epidermis, inducing beneficial wound healing with a few side‐effects …”

Is skin microneedling a good alternative method of various skin defects removal

“…A similar penetration of pharmaceuticals was confirmed also with the use of dermaroller just before the substance application (Šuca et al, ). Moreover, the increase in transepidermal drug delivery is observed for at least 72 hr after the procedure (Lima, Lima, Paixão, & Miot, ). The microtraumatization creates micropores, which results in increased transdermal water loss (Šuca et al, ), however, the result of the study has demonstrated that prompt recovery of skin barrier function is achieved within several hours from device usage (Shah, Shah, Solanki, & Raval, ).…”

Microneedles: a therapeutic alternative in melasma

“…20 The long-term improvement of recalcitrant melasma after micro needle treatment has been reported in case series studies, however, the exact mechanism that promotes skin clearance is unknown. 18,19 In a small study conducted in patients from the northeast of Brazil by Lima and colleagues, after the performance of 2sessions with micro needles subjective improvement of the skin smoothness and greater luminosity in patients with recalcitrant melasma was observed. A decrease of 70% in the MASI, 13% increase in luminosity and 55% decrease in the melasma quality of life scale was evidenced.…”

“…The micro needles began to be used for the treatment of acne scars and it was observed that in patients with concomitant melasma, there was an improvement in the decrease of the pigment in the skin. 18,19 In this way, it was begun to be explored as a means of transdermal drug administration in a population with Fitzpatrick III-IV-V phototype, for the treatment of hyper pigmentation disorders. 20 The long-term improvement of recalcitrant melasma after micro needle treatment has been reported in case series studies, however, the exact mechanism that promotes skin clearance is unknown.…”