Microneedling with topical ascorbic acid in the treatment of melasma
Keywords:
Melasma; Microneedling; Topical ascorbic acidAbstract
Objective To assess the outcome of microneedling with topical ascorbic acid (Vitamin C) in the treatment of melasma. Methods In this non- randomized, pre-post interventional study,60 females with age range of 20 -45 years, fulfilling the inclusion and exclusion criteria, were enrolled. The study was carried out in the department of Dermatology, Mayo Hospital/ King Edward Medical University, during the six month period from 21/09/2021 to 20/03/2022. Topical application of 20% ascorbic acid aqueous solution was done on affected area after microneedling with dermaroller. Patients were instructed to follow strict photo-protective measures. Follow-up was done every 2 weeks for a total of six sessions and then follow up visit, after 1 month of last session. SPSS 23 was used for analysing data. Results Mean age of the patients was 33.5±4.3 years. Mean duration of melasma was 2.9±1.1 years. Percentage reduction in mMASI score observed was 38.3±8.2, with means of pre-treatment and post-treatment mMASI score of 13.17±1.09 and 8.10±1.11, respectively, (p-value=0.004). Melasma types were as follows: Epidermal 42 (70%), dermal 4 (6.7%) and mixed 14 (23.3%).Out of 60 women, 7 patients (11.7%) were having Fitzpatrick skin type III and 53 patients (88.3%) were having type IV. Conclusion In conclusion, microneedling with topical vitamin C is an effective treatment option for melasma in Fitzpatrick skin phototypes III-IV. It is a safe treatment modality with minimal and transient side effects.References
Menon A, Eram H, Kamath PR, Goel S, Babu AM.A Split Face Comparative Study of Safety and Efficacy of Microneedling with Tranexamic Acid versus Microneedling with Vitamin C in the treatment of Melasma. Indian Dermatol Online J. 2019;11:41-5.
Ogbechie-GodecOA,Elbuluk N. Melasma:An Up-to-Date Comprehensive Review. Dermatol Ther. 2017;4:305-18.
Liu Y, WU S,WUH, LiangX, Guo D, Zhuo F. Comparison of the Efficacy of Melasma Treatments: A Network Meta-Analysis of Randomized Controlled Trials. Front Med. 2021;8:713554.
McKesey J, Tovar-Garza A, Pandya AG. Melasma Treatment: An Evidence-Based Review. Am J Clin Dermatol. 2020;21:173-225.
Rajanala S, Maymone MBC, Vashi NA.Melasma Pathogenesis: a review of the latest research,pathological findingsand investigational therapies. Dermatol Online J. 2019;25:10.
Sarkar R, Bansal A, Ailawadi P. Future therapies in melasma: What lies ahead? Indian J Dermatol Venereol Leprol. 2020;86:8-17.
Bosamiya SS, Jain SM. A Pilot Study to Compare Therapeutic Efficacy and Safety of Combined Treatment of Skin Microneedling and Depigmenting Cream versus Depigmenting Cream alone in Facial Melasma at Tertiary Care. J Cutan Aesthet Surg. 2021;14:156-9.
Ismail ESA, Patsatsi A, Abd El-Maged WM, Nada EEAE. Efficacy of microneedling with topical vitamin C in the treatment of melasma. J Cosmet Dermatol. 2019;18:1342-7.
Goel B. To Study the Efficacy of microneedling with topical vitamin c in the treatment of melasma. J Dent Med Sci. 2020;19:16-29.
Ortonne JP, Arellano I, Berneburg M, Cestari T, Chan H, Grimes P, et al. A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma. J Eur Acad Dermatol Venereol. 2009;23:1254-62.
Neagu N, Conforti C, Agozzino M, Marangi GF, Morariu SH, Pellacani G et al. Melasma treatment: a systematic review. J Dermatolog Treat. 2022;23:1-22.
EI Attar Y, Doghaim N, EI Hedody S, Hawwam SA. Efficacy and Safety of tranexamic acid versus vitamin C after microneedling in treatment of melasma: Clinical and Dermatological study. J Cosmet Dermatol.2021;10:1111.
Raza MH, Iftikhar N, Anwar A, Mashhood AA, Bin Hamid MA. Spilt Face Comparative Analysis of Micro-Needling with Tranexamic Acid Vs Vitamin C Serum in Melasma. J Ayub Med Coll.2022;34:169-72.
Abdel-Rehman AT, Abdel-Hakeem FG, Ragaie MH. Clinical, dermoscopic, and histopathologic evalution of vitamin C versus PRP, with microneedling in the treatment of mixed melasma: A split-face, comparative study. Dermatol Ther. 2022;35:10.
Tahoun AI, Mostafa WZ, Amer MA. Dermoscopic evaluation of tranexamic acid versus vitamin C, with microneedling in the treatment of melasma: a comparative, split – face, single–blinded study. J Dermatolog Treat.2021;12:1-7.
