Melasma, a common, chronic condition, possesses treatment-challenging cosmetic concerns. The present study thus systematically evaluated clinical studies evaluating the treatment of melasma through needling while focusing on efficiency, safety and recurrence.

The study reviewed 54 articles and finalized 12 published articles, which included open pilot trials, case reports, case series, retrospective studies, quasi-experimental trials, randomized clinical trials and split-face comparative studies.

The study observed:

• The highest decrease in MASI score was 85.71% and allocated to the microneedling method following only three sessions with an interval of 30 days. 
• The lowest decrease in this score was 3.7% and allocated to microneedling treatment and its use for vitamin C delivery at the end of the fourth week of treatment. 
• The studies reported no side effects and regarded the various needling methods as safe. 
• None of the articles reported recurrence after treatment, and only one of them reported a 4% recurrence in the second phase of treatment but reported no recurrence in the last phase of that study.

This study shows that nonaggressive microneedling with topical depigmenting agents is more effective than topical depigmenting agents alone. It renders a significantly higher mean MASI score than those using lightning serum alone. Hence, needling is an effective and safe method with a low recurrence rate for treating melasma.

Source: J Cosmet Dermatol. 2022;21(5):1857-73.