Microneedling as an adjuvant to topical therapies for melasma: A systematic review and meta-analysis

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#administration-cutaneous #ascorbic-acid #humans #melanosis #prospective-studies

Microneedling as an adjuvant to topical therapies for melasma: A systematic review and meta-analysis

Bailey et al., 2022 | J Am Acad Dermatol | Meta Analysis

Citation

Bailey Adrian Joseph Michel, Li Heidi Oi-Yee, ... Dover Jeffrey S. Microneedling as an adjuvant to topical therapies for melasma: A systematic review and meta-analysis. J Am Acad Dermatol. 2022-Apr;86(4):797-810. doi:10.1016/j.jaad.2021.03.116

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 microneedling as an adjuvant to topical therapies for 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 7 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 (standardized mean difference >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 designs did not allow for a comparison of the efficacy of various topical therapies with microneedling. CONCLUSION: Microneedling is useful adjuvant to topical therapies for the treatment of melasma.

Key Findings

Twelve eligible studies comprising 459 patients from 7 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 (standardized mean difference >0.8) beyond 8 weeks, with best results seen at 12 weeks. Compared to topical therapy alone, topical therapy with microneedl

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 459
Age Range See abstract
Condition See abstract

MeSH Terms

  • Administration, Cutaneous
  • Ascorbic Acid
  • Humans
  • Melanosis
  • Prospective Studies
  • Tranexamic Acid
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: vitamin-c

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09