Saher Gul, Syed Ahmad Ali Gardezi, Attiya Arshad, Tahir Jamil Ahmad, Shahbaz Aman, Shehla Shaukat.
Microneedling with topical ascorbic acid in the treatment of melasma.
J Pak Assoc Derma Jan ;33(2):547-52.

Objective: To assess the outcome of microneedling with topical ascorbic acid (Vitamin C) in the treatment of melasma.   Methods: In this non- randomized, pre-post interventional study,60 females with age range of 20 -45 years, fulfilling the inclusion and exclusion criteria, were enrolled. The study was carried out in the department of Dermatology, Mayo Hospital/ King Edward Medical University, during the six month period from 21/09/2021 to 20/03/2022. Topical application of 20% ascorbic acid aqueous solution was done on affected area after microneedling with dermaroller. Patients were instructed to follow strict photo-protective measures. Follow-up was done every 2 weeks for a total of six sessions and then follow up visit, after 1 month of last session. SPSS 23 was used for analysing data.   Results: Mean age of the patients was 33.5±4.3 years. Mean duration of melasma was 2.9±1.1 years. Percentage reduction in mMASI score observed was 38.3±8.2, with means of pre-treatment and post-treatment mMASI score of 13.17±1.09 and 8.10±1.11, respectively, (p-value=0.004). Melasma types were as follows: Epidermal 42 (70%), dermal 4 (6.7%) and mixed 14 (23.3%).Out of 60 women, 7 patients (11.7%) were having Fitzpatrick skin type III and 53 patients (88.3%) were having type IV.   Conclusion: In conclusion, microneedling with topical vitamin C is an effective treatment option for melasma in Fitzpatrick skin phototypes III-IV. It is a safe treatment modality with minimal and transient side effects.  

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