Microneedling in vitiligo: A systematic review

Abstract

Microneedling was initially introduced for skin rejuvenation; however, this minimally invasive procedure is now being used for the treatment of multiple dermatological conditions. Recent reports have shown its efficacy in the treatment of vitiligo. This review analyzes the current literature on microneedling techniques, efficacy, and safety for vitiligo treatment. An extensive PubMed was done to identify the literature on microneedling treatment for vitiligo. Case reports, case series, and clinical trials were included in this review. All 14 articles evaluated showed improvement of vitiligo lesions after microneedling treatment. The combination of microneedling and topical tacrolimus, 5-fluorouracil, topical calcipotriol and betamethasone, narrowband ultraviolet B with or without photodynamic therapy, and triamcinolone acetonide solution yielded more efficacy than microneedling monotherapy. Microneedling is a safe and efficient technique in the treatment of vitiligo. Thus, it can be an alternative treatment for vitiligo especially when the latter is resistant to conventional therapies.

A comparative study of combined microneedling and narrowband ultraviolet B phototherapy versus their combination with topical latanoprost in the treatment of vitiligo

“…18 The combination of microneedling with various topical therapeutic medications for vitiligo was reported to induce more successful outcomes than any of them alone. 13 The current study reported various degrees of repigmentation of vitiligo lesions in 75% of all studied patients in response to microneedling combined with NB-UVB phototherapy. These findings were in accordance with Giorgio et al, 6 T A B L E 1 Comparison between both treatment sides in the studied patients (n = 50) The results of the present study were in accordance with that reported by Korobko and Lomonosov, 9 and better than that achieved by Stanimirovic et al 8 The modified treatment parameters performed in the current study (needle length [1.5-2.0 mm], frequency of microneedling session [once every 2 weeks], and duration of the treatment up to 6 months) might explain our superior results.…”

“…Furthermore, microneedling induces microtraumas of the basal cell layer with subsequent increase of the dermal melanophages aiding in repigmentation 10 . In addition, microneedling procedure promotes migration of melanocytes from a melanocytes reservoir either at the periphery of the vitiliginous patch or any perifollicular pigment within the lesion and their autoinoculation by the tip of the needles in the depigmented areas 5,10,13 . All of these factors can participate in activation of melanogenesis.…”

“…The rational for microneedling in vitiligo is to induce processes similar to wound healing response by needle piercing with concomitant production of cytokines and growth factors beneficial for repigmentation, particularly transforming growth factor (TGF‐β), platelet‐derived growth factor (PDGF), and inflammatory mediators such as leukotriene C4 10,13 . Furthermore, microneedling induces microtraumas of the basal cell layer with subsequent increase of the dermal melanophages aiding in repigmentation 10 .…”

“…It induces processes similar to wound healing with production of cytokines and growth factors beneficial for repigmentation. In addition, it facilitates drug penetration through the skin, which might potentiate their activity 13 …”

“…In addition, it facilitates drug penetration through the skin, which might potentiate their activity. 13 Latanoprost is a topical ophthalmic medication used for treatment of glaucoma by decreasing intraocular pressure. It is a prostaglandin analogue, more specifically an analogue of prostaglandin F2 alpha (PGF2α) that works by increasing the outflow of aqueous fluid from the eyes.…”