Microneedling with glutathione versus microneedling alone in treatment of facial melasma: Split-face comparative study

BackgroundMelasma is a distressing disfiguring acquired pigmentary disorder especially affecting females and it is of high tendency of recurrence. Up till now, treatment of melasma is a challenging problem. ObjectivesWe evaluated the effectiveness of microneedling with glutathione versus microneedling alone in treatment of melasma. Patients and MethodsIn this study, 29 adult females with epidermal type of melasma (confirmed with Wood's light examination) were enrolled. The affected area was subjected to microneedling using dermapen followed by application of glutathione solution on the right side only. This session was performed every 2 weeks for 3 months (six sessions for every patient). The response to therapy was measured using modified melasma area and severity index (m MASI) that were calculated on each side of the face (Hemi- m MASI) before treatment sessions. ResultsThere was statistically significant reduction in the mean of Hemi- m MASI score over the sessions on both sides of the face but the right side (microneedling with glutathione) showed more reduction and earlier response to therapy than the left side (microneedling alone). On the left side, mean of Hemi- m MASI score before and after sessions was (4.06 +/- 1.91, 2.31 +/- 1.450) and on the right side, it was (4.21 +/- 2.08, 1.96 +/- 1.30), respectively and this was statistically significant. Percentage of improvement on the left side was 46.92 +/- 16.30 (%) while on the right side was 55.17 +/- 15.50 (%) and this was statistically significant. ConclusionsMicroneedling is an effective promising tool in treatment of melasma and its combination with glutathione as a whitening agent, increases and accelerates its efficacy. So, combined therapy is more preferred than monotherapy in treatment of facial melasma.