Clinical Observation of Roller Microneedling Combined with Topical Tranexamic Acid for Melasma

LU Yaqing; XUN Shan; YANG Li; WEI Yan; XU Yan; LI Xueli

doi:10.11786/sypfbxzz.1674-1293.20260108

Abstract：Objective To evaluate the efficacy and safety of roller microneedling combined with topical tranexamic acid for treating melasma.Methods From June to July 2024,60 female patients with stable melasma who presented at Henan Provincial People's Hospital were enrolled and randomized into a treatment group(n=30)and a control group(n=30).The control group applied topical tranexamic acid serum twice daily.The treatment group received the same topical regimen plus roller microneedling performed every 4 weeks for a total of 3 sessions;after each session,a tranexamic acid-containing revitalizing serum was applied within 24 hours.Outcomes compared between groups included Melasma Area and Severity Index(MASI),skin colorimetric parameters(L*,a*,b*),Dermatology Life Quality Index(DLQI),and patient satisfaction.Adverse events during treatment were recorded.Assessments were made at baseline and at 12 weeks(end of treatment).Results At 12 weeks,both groups showed significant reductions in MASI,a*,and b* values(P<0.05),and significant increases in L* values(P<0.05).The treatment group demonstrated significantly greater improvements than the control group in MASI,a*,b*,and L*(all P<0.05).DLQI scores decreased significantly in both groups(P<0.05),with a larger reduction in the treatment group(P<0.05).Patient satisfaction was higher in the treatment group(86.67%)than in the control group(63.33%)(P<0.05).Only one patient in the treatment group reported mild pain during treatment,which resolved with cold compress;no post-inflammatory hyperpigmentation or serious adverse events were observed.Conclusion Roller microneedling combined with topical tranexamic acid is effective and safe for melasma.