A Face-Split Study to Evaluate the Effects of Microneedle Radiofrequency with Q-Switched Nd:YAG Laser for the Treatment of Melasma

BACKGROUND: Laser toning using a low-fluence 1,064 nm Q-switched Nd:YAG laser is one of the most frequently used treatment modalities for melasma. However, this therapy is time consuming because it requires a lot of treatment sessions. Recently, it has been reported that transdermal radiofrequency (RF) is effective for the treatment of melasma. OBJECTIVE: To determine whether microneedle RF conduction could be an adjunct therapy for melasma, we have studied the effect of simultaneous treatments with laser toning and RF for melasma. METHODS: Fifteen patients with melasma underwent five sessions of laser toning and microneedle RF on the right side of the face, and only laser toning on the left side. Responses to treatments were evaluated using the Mexameter® (Courage Khazaka, Germany) score, the pigmentation and severity index (PSI) score, and the patient's overall assessment. Additionally, an electron microscopic study of a skin biopsy was performed. RESULTS: Both laser toning and combination therapy showed significant decreases in the Mexameter® and PSI score after five treatment sessions. Combination therapy showed a more significant improvement of melasma than laser toning. No remarkable side effects were reported. Electron microscopic analysis showed a greater number of vacuolar changes and increased loosening of melanocytes and adjacent epidermal cells after combination therapy. CONCLUSION: The combination treatment of laser toning and microneedle RF therapy showed a better therapeutic effect for melasma than laser toning alone. Therefore, the microneedle RF technique could be a new and safe adjunct therapy for the treatment of melasma.