Efficacy of microneedling with topical vitamin C in the treatment of melasma

Abstract

Summary Background Despite the wide therapeutic options available for the treatment of melasma, including many active topical medications, technologies with lights and peelings, clinical control of this disorder is extremely challenging. Objectives To evaluate the effect of microneedling with topical vitamin C in the treatment of melasma. Methods Thirty female patients with melasma received six sessions of microneedling with addition of topical vitamin C every two weeks. At each session, photos were taken and Melasma Area and Severity Index (MASI) score was calculated to assess the clinical improvement. Results Mean age of the eligible patients was 33.2 ± 5.77 years. About 50% of cases were of Fitzpatrick skin type III. All patients showed improvement at the end of the sessions. Mean MASI score in the first session was 8.61 ± 4.45 and there was a gradual decline in its value till it reached a mean of 5.75 ± 4.16 in the last session (P < 0.0001). Conclusion Microneedling with topical vitamin C is an effective and safe treatment option for epidermal melasma especially in Fitzpatrick skin phototypes I‐III.

Effective lightening of facial melasma during the summer with a dual regimen: A prospective, open‐label, evaluator‐blinded study

“…Acknowledging that hypersensitivity and foreign‐body reactions may occur with laser‐assisted or microneedling‐assisted delivery of ascorbic acid, 14 research studies have been conducted to determine if coupling these modalities is effective 24,25 . A clinical trial coupled microneedling with 20% ascorbic acid for melasma treatment and found a 12.3% improvement in Melasma Area and Severity Index (MASI) score at 8 weeks 24 .…”

“…A clinical trial coupled microneedling with 20% ascorbic acid for melasma treatment and found a 12.3% improvement in Melasma Area and Severity Index (MASI) score at 8 weeks 24 . In addition, another clinical trial evaluated the effect of microneedling with topical 20% L‐ascorbic acid every 2 weeks for 3 months and found a 37% improvement in MASI score 25 . However, as with treating any patient, one has to consider all variables—risks, benefits and possible side effects—and given the higher risk of local cutaneous as well as systemic reactions to transdermal drug delivery of ascorbic acid, laser‐assisted or microneedling‐assisted delivery of this compound should be approached very judiciously if at all.…”

The efficacy and safety of topical tranexamic acid (liposomal or lotion with microneedling) versus conventional hydroquinone in the treatment of melasma

“…The TA liposomal formulation was found to be effective because of its enhanced drug delivery, improved moisturizing effect with longer action, and controlled tissue drug distribution 21,22 . Microneedling could enhance the delivery of TA with relatively intact epidermis and limited adverse effects 23 . Furthermore, the procedure of microneedling could solely improve melasma by stimulating the proliferation of fibroblasts, the release of growth factors, and the upper dermal collagen formation 24,25 .…”

The top 10 cosmeceuticals for facial hyperpigmentation

“…with topical vitamin C to be a significantly effective and safe treatment, particularly for those of Fitzpatrick skin types I-III. 17 In a separate study, patients were treated with full-face iontophoresis mask and vitamin C (ascorbyl glucoside) preparation. 18 Patients had one treatment and 12 to 24 home treatments over 1 to 2 months with sun avoidance advised.…”

“…Another study of 30 patients found microneedling (six sessions) with topical vitamin C to be a significantly effective and safe treatment, particularly for those of Fitzpatrick skin types I‐III 17 …”