Graduate Program in Pharmaceutical Science and Technology, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
J Cosmet Dermatol. 2022 Nov;21(11):5680-5695. doi: 10.1111/jocd.15287. Epub 2022 Sep 25.
Melasma is an acquired hyperpigmentation disorder. Microneedling is an alternative treatment for melasma especially by improving penetration of pharmacological agents into the skin.
The main objective of this review was to systematize and analyze available evidence on the efficacy and safety of microneedling alone or associated with topical agents in reducing skin stains and improving melasma-related quality of life in adult patients.
Only randomized clinical trials were included. The following databases were consulted: MEDLINE, Embase, Cochrane, and the gray literature. The Cochrane risk-of-bias tool for randomized trials (RoB 2.0) was used to assess risk of bias.
The search retrieved 719 records and seven studies were included. A total of 368 participants (96.19% women) were evaluated. Two studies were split-face. Most of the studies evaluated microneedling associated with tranexamic acid. High risk of bias was presented by most studies, especially in the safety outcome. A significant decrease was observed in the MASI, mMASI, or hemi-MASI scores, regardless of the topical agents associated. Meta-analysis was not possible due to the heterogeneity of the studies.
Based on the results of this review, microneedling can, in association with topical agents or isolated, be used safely in the treatment of melasma in the clinical practice, obtaining results on reduction of stain severity and improvement of patients' quality of life.
黄褐斑是一种获得性色素沉着障碍。微针治疗是一种治疗黄褐斑的替代方法，特别是通过改善药物对皮肤的渗透。
本综述的主要目的是系统地分析和评估微针单独或联合局部药物治疗成人患者皮肤色斑和改善与黄褐斑相关的生活质量的疗效和安全性的现有证据。
仅纳入随机临床试验。检索了以下数据库：MEDLINE、Embase、Cochrane 和灰色文献。使用 Cochrane 随机试验偏倚风险工具（RoB 2.0）评估偏倚风险。
搜索共检索到 719 条记录，纳入了 7 项研究。共评估了 368 名参与者（96.19%为女性）。其中两项研究为半脸对照。大多数研究评估了微针联合氨甲环酸。大多数研究都存在较高的偏倚风险，尤其是在安全性结局方面。无论联合何种局部药物，MASI、mMASI 或半 MAS I 评分均显著下降。由于研究的异质性，无法进行荟萃分析。
根据本综述的结果，微针治疗联合或不联合局部药物治疗黄褐斑在临床实践中是安全的，可以获得减轻色斑严重程度和改善患者生活质量的效果。
