Institute of Medical Sciences and SUM Hospital, S 'O'A University, Bhubaneswar, India.
J Cosmet Dermatol. 2022 Jul;21(7):2801-2807. doi: 10.1111/jocd.14532. Epub 2021 Oct 12.
Treatment of melasma is challenging. Topical TA has shown promising results as an adjuvant, when combined with microneedling or QS Nd:YAG laser. The efficacy of both combinations has been demonstrated but the efficacy between these two combinations has never been compared.
To compare the efficacy and side effects of microneedling and QS Nd:YAG laser when combined with topical 3% TA gel.
60 patients were randomized into 2 groups. Group A received Nd:YAG laser sessions monthly with daily 3% TA gel while Group B underwent microneedling monthly with daily 3% TA gel. A total of 5 sessions were given with follow-up after 2 months. Evaluation using modified Melasma Area and Severity Index (mMASI), Patient satisfaction score, and photography was done at baseline, 3rd session, 5th session, and final follow-up.
Mean fall in mMASI at follow-up in Group A was 5.12 ± 2.66 to 2.33 ± 1.33 and Group B was 4.60 ± 2.38 to 1.88 ± 1.08 (p < 0.001). Patient satisfaction score was not significantly different. Side effects of both interventions included erythema, pain, and burning sensation.
Our study shows equal efficacy of microneedling and QS Nd:YAG laser when combined with topical 3% TA gel in treating melasma without serious side effects. Microneedling has more downtime and maybe less preferable as a lunchtime procedure.
治疗黄褐斑具有挑战性。局部 TA 已显示出作为辅助治疗的有希望的结果，当与微针或 QS Nd：YAG 激光联合使用时。这两种组合的疗效都得到了证实，但这两种组合的疗效从未被比较过。
比较微针和 QS Nd：YAG 激光联合外用 3%TA 凝胶的疗效和副作用。
将 60 例患者随机分为 2 组。A 组每月接受 Nd：YAG 激光治疗，同时每天使用 3%TA 凝胶；B 组每月接受微针治疗，同时每天使用 3%TA 凝胶。共进行 5 次治疗，2 个月后随访。在基线、第 3 次治疗、第 5 次治疗和最终随访时，使用改良黄褐斑面积和严重程度指数（mMASI）、患者满意度评分和摄影进行评估。
A 组在随访时 mMASI 的平均下降为 5.12 ± 2.66 至 2.33 ± 1.33，B 组为 4.60 ± 2.38 至 1.88 ± 1.08（p < 0.001）。患者满意度评分无显著差异。两种干预措施的副作用均包括红斑、疼痛和烧灼感。
我们的研究表明，微针和 QS Nd：YAG 激光联合外用 3%TA 凝胶治疗黄褐斑的疗效相同，无严重副作用。微针治疗的停机时间更长，可能不太适合作为午休时间的治疗方法。
