Efficacy of microneedling with topical vitamin C in the treatment of melasma

Background: Despite the wide therapeutic options available for the treatment of melasma, including many active topical medications, technologies with lights and peelings, clinical control of this disorder is extremely challenging. Objectives: To evaluate the effect of microneedling with topical vitamin C in the treatment of melasma. Methods: Thirty female patients with melasma received six sessions of microneedling with addition of topical vitamin C every two weeks. At each session, photos were taken and Melasma Area and Severity Index (MASI) score was calculated to assess the clinical improvement. Results: Mean age of the eligible patients was 33.2 +/- 5.77 years. About 50% of cases were of Fitzpatrick skin type III. All patients showed improvement at the end of the sessions. Mean MASI score in the first session was 8.61 +/- 4.45 and there was a gradual decline in its value till it reached a mean of 5.75 +/- 4.16 in the last session (P < 0.0001). Conclusion: Microneedling with topical vitamin C is an effective and safe treatment option for epidermal melasma especially in Fitzpatrick skin phototypes I-III.