Background: Melasma, characterized by irregular skin hyperpigmentation, presents a therapeutic challenge with limited universal solutions. Platelet-rich plasma (PRP) and Tranexamic Acid (TXA), coupled with microneedling, offer promising avenues for treatment. This clinical trial sought to compare the efficacy and adverse effects of microneedling with PRP versus TXA in managing melasma. Methods: The study was a single-blind, randomized controlled trial from May 2022 to Apr 2023 and enrolled 23 female melasma patients. Using the coin toss method, patients were randomly assigned to receive microneedling with PRP on one side and microneedling with TXA on the other. Evaluation parameters included Melasma Area and Severity Index (MASI) scores, melasma improvement grading, patient satisfaction, and treatment-related side effects, monitored over three sessions at 3-week intervals. Results: Both microneedling approaches demonstrated effectiveness, with the PRP group exhibiting significantly lower MASI scores at the 6th and 9th wk. However, no significant distinctions were observed in improvement grading or patient satisfaction between the PRP and TXA groups. Side effects were minimal, limited to transient burning and mild pain during the procedure. Conclusion: microneedling with PRP and TXA emerged as a safe and effective treatment for melasma. While the PRP group showed potential superiority in MASI scores, comprehensive considerations, including patient preferences and long-term outcomes, are crucial. Larger, multi-center studies with extended follow-up periods are warranted for a more nuanced understanding of these treatments in melasma management.

Background: Vitiligo, a pigmentary skin disorder, poses therapeutic challenges due to its progressive nature and varied treatment responses. We aimed to investigate the efficacy of a novel approach, combining microneedling with topical 5-Fluorouracil (5-FU), compared with microneedling with Fluocinolone and microneedling alone for treating vitiligo lesions. Methods: A single-blinded clinical trial was conducted from Aug 2022 to Feb 2023 at Ahvaz University of Medical Sciences, Ahvaz, Iran. Twenty patients with persistent vitiligo lesions were randomly assigned to three treatment groups. microneedling was performed using Dermapen cartridge 36 once a week for 12 wk. In patch A, 5% 5-FU cream was applied immediately after microneedling; in patch B, patients used fluocinolone 0.025% cream twice daily; and in patch C, microneedling was performed alone. Clinical repigmentation was evaluated using the G-score scale, and treatment side effects were recorded. Results: microneedling combined with 5-FU demonstrated significantly higher repigmentation rates, with 70% of lesions showing moderate to excellent responses (P<0.001). In contrast, microneedling with Fluocinolone and microneedling alone exhibited lower response frequencies. Side effects were minimal, with only one patient experiencing burning and itching in the microneedling and 5-FU group. No corticosteroid-related complications were observed. Six months follow-up revealed sustained repigmentation in the microneedling and 5-FU group, contrasting with no response or recurrence in microneedling alone-treated lesions. Conclusion: microneedling combined with topical 5-FU presents a promising therapeutic strategy for vitiligo lesions, yielding superior repigmentation outcomes compared to other treatments.

2Background and Aim: Skin aging is a natural process, and microneedling is a method used for skin rejuvenation. This study aimed to evaluate the impact of microneedling on reducing perioral wrinkles. Methods: A clinical trial was conducted on 30 women referred to a skin clinic in Isfahan, Iran, from December 22, 2021, to June 20, 2022. The patients underwent three microneedling sessions at 2-week intervals. Perioral wrinkles were photographed using a digital camera under consistent conditions and at a distance of 30 cm before the intervention, 6 weeks post-intervention, and 3 months after the final treatment session. Two dermatologists, blinded to the treatment, assessed the photographs. Moreover, patients self-reported improvement using the Visual Analog Scale (VAS) at the beginning, 6 weeks, and 3 months after the intervention. Results: Following the microneedling sessions, the first dermatologist reported poor improvement in 7 (23.3%), moderate improvement in 14 (46.7%), good improvement in 7 (23.3%), and excellent improvement in 2 (6.7%) cases. The second dermatologist observed good improvement in 13 (43.3%), moderate in 11 (36.7%), and poor improvement in 6 (20%) patients. According to patient reports, perioral wrinkles showed significant improvement at 6 weeks and 3 months post-intervention compared to baseline (P<0.001). Additionally, there was a significant improvement in perioral wrinkles at 3 months compared to 6 weeks post-intervention (P<0.001). Conclusion: The results suggest that three microneedling sessions at 2-week intervals led to a significant improvement in perioral wrinkles based on assessments by dermatologists and patient reports.

Background: microneedling is widely used in dermatology due to its effectiveness and favorable safety profile. It promotes dermal collagen and elastin remodeling, thereby improving skin texture, scars, photodamage, and pigmentation disorders. Despite its popularity, microneedling can cause side effects and complications. This study aims to assess the adverse effects of microneedling and to investigate their relationship with demographic and clinical factors. Methods: This cross-sectional study included patients treated with microneedling at Razi Hospital for facial skin conditions. Demographic data, including age, sex, and indication for treatment, were collected prior to treatment. One-month post-procedure, patients were surveyed regarding side effects such as post-inflammatory hyperpigmentation, hypopigmentation, persistent erythema, and itching. The relationship between adverse effects and demographic factors was analyzed. Results: A total of 120 patients participated, with a mean age of 32. 41 ± 7. 44 years. The majority were women (86. 7%), and treatment indications included scars (76. 6%), melasma (10. 8%), and skin rejuvenation (12. 5%). Reported side effects included hyperpigmentation in 6. 7%, hypopigmentation in 1. 7%, persistent erythema in 2. 5%, and itching in 9. 2% of patients. Patients with persistent erythema were significantly younger than those without this complication (P = 0. 001). No significant relationship was found between adverse effects and either sex or treatment indication. Conclusion: Itching was the most frequently reported side effect, followed by hyperpigmentation, persistent erythema, and hypopigmentation. Clinicians should address these adverse effects, particularly in younger patients, to ensure optimal care following microneedling.  

Background: Vitiligo is an acquired disease with unknown cause and one of the major challenges in dermatology. The aim of this study was to evaluate the therapeutic efficacy of microneedling in combination with topical liposomal form of 5-fluorouracil (5-FU) 5% in treatment of vitiligo. Methods: This study was performed as a randomized clinical trial on 25 patients with vitiligo referred to the dermatology clinics of Imam Reza and Ghaem hospitals in Mashhad City, Iran. In each patient, three lesions were selected and microneedling with liposomal form of 5-FU 5% and only microneedling were performed on one of them by random allocation. The third lesion was considered as a control without any intervention. This process was done every 2 weeks for 3 months, and the rate of improvement was assessed after 6 months. Findings: 68% of lesions (17 persons) treated with microneedling and 5-FU had significant repigmentation, 12% with 25%-50% improvement and 56% with improvement up to 25%. However, response rate of lesions treated with microneedling alone was 32%, 4% with 25%-50% improvement and 28% with improvement up to 25%. Statistical analysis of data with generalized estimating equation (GEE) method showed that in terms of response to treatment, the lesions treated with microneedling and 5-FU had a significant difference with microneedling alone and also with control lesions (P < 0. 050). Conclusion: According to our findings, the combined use of microneedling with topical 5-FU significantly improves resistant vitiligo lesions compared to microneedling method alone.

Treating facial pigmentation disorders has become controversial, with patients requesting less invasive and more effective treatments that minimize side effects. microneedling, combined with platelet-rich plasma (PRP), has recently emerged as a common treatment in the field of aesthetic medicine, with numerous articles highlighting its use in restorative treatments and its effectiveness. However, there have been no reports to date on the use of this technique for addressing facial pigmentation disorders. In this article, we present a successful case study utilizing microneedling in combination with PRP to eliminate facial pigmentation. Based on the available evidence, it appears that this treatment approach is highly effective and carries minimal risk of side effects when used to address facial pigmentation.