Bailey Adrian Joseph Michel, Li Heidi Oi-Yee, Tan Marcus G, Cheng Wei, Dover Jeffrey S
Faculty of Medicine, The University of Ottawa, Ottawa, Ontario, Canada.
Faculty of Medicine, The University of Ottawa, Ottawa, Ontario, Canada; Division of Dermatology, The Ottawa Hospital, Ottawa, Ontario, Canada.
J Am Acad Dermatol. 2022 Apr;86(4):797-810. doi: 10.1016/j.jaad.2021.03.116. Epub 2021 Apr 12.
Microneedling as an adjuvant to topical medications has shown promising but variable results in the treatment of melasma.
To conduct a systematic review and meta-analysis on the efficacy of microneedling as an adjuvant to topical therapies for the treatment of melasma.
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.
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.
Heterogeneity in study designs did not allow for a comparison of the efficacy of various topical therapies with microneedling.
Microneedling is useful adjuvant to topical therapies for the treatment of melasma.
微针疗法作为局部用药的辅助手段，在黄褐斑治疗中已显示出有前景但效果不一的结果。
对微针疗法作为局部治疗黄褐斑辅助手段的疗效进行系统评价和荟萃分析。
本研究遵循PRISMA指南。纳入所有关于使用局部干预联合微针疗法治疗黄褐斑的比较性前瞻性研究。排除涉及射频微针的研究。
纳入了12项符合条件的研究，共459例患者，来自7个不同国家。局部治疗包括局部应用氨甲环酸、维生素C、富血小板血浆、非氢醌类脱色血清和氢醌类脱色剂。微针联合局部治疗在8周后可显著改善黄褐斑严重程度（标准化均数差值>0.8），12周时效果最佳。与单纯局部治疗相比，微针联合局部治疗在8周时可使黄褐斑严重程度有中度改善，在12至16周时有显著改善。在各项研究中，微针疗法耐受性良好，未报告严重不良事件。
研究设计的异质性使得无法比较各种局部治疗联合微针疗法的疗效。
微针疗法是治疗黄褐斑局部治疗的有用辅助手段。
