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 Center

BACKGROUND: Melasma is a commonly acquired, chronic, and relapsing disorder that results in symmetrical, brownish facial pigmentation. It is more common in women than in men, which generally starts between 20 and 40 years of age, and it can lead to considerable embarrassment and distress. Managing melasma is a difficult challenge that requires long-term treatment with a number of topical agents. Microneedling has been described as a new technique to enhance the drug’s transdermal penetration, and has also been reported to result in sustained long-term improvement of recalcitrant melasma. AIM: The aim of this article was to compare the therapeutic efficacy and safety of combined treatment of skin microneedling and depigmenting cream versus depigmenting cream alone in the treatment of melasma. MATERIALS AND METHODS: A prospective study was conducted with a sample size of 40 patients, with twenty in each of the treatment arms; 20 patients were treated with combined skin needling and depigmenting cream and 20 with depigmenting cream alone. The outcome was evaluated periodically for up to 2 months using the modified Melasma Area and Severity Index (MASI) score. RESULTS: Significant reduction was observed in modified MASI score in the combined treatment, with P value <0.05. CONCLUSION: Combining microneedling with Kligman’s regimen gives better results in melasma treatment compared to topical treatment alone.