Targeting the dermis for melasma maintenance treatment

Abstract

Abstract Background: Melasma relapse is almost common after discontinuation of conventional treatment. Recent studies have suggested that photoaging dermis is main pathomechanism of melasma emphasizing stromal targeting therapy. Objectives: We investigated maintenance effect of microneedling radiofrequency (RF) for melasma treatment. Methods: Subjects with melasma were administered oral tranexamic acid and triple combination cream for two months and a randomly assigned half face was treated with RF. After discontinuation of conventional therapy, the half face RF continued monthly over 6 months. Modified melasma area severity index (mMASI) score and L* value by a chromameter were collected monthly. Results: Fifteen patients were enrolled and eleven completed the 8-month study. At 2nd month of conventional therapy, all subjects showed improvement with a 64% reduction in mMASI score. With continuous RF treatment, the improvement was well maintained; whereas in untreated side, the Δ L* gradually decreased, returning to the baseline after the conventional therapy ended. Conclusions: The continuous RF therapy is beneficial in maintaining the conventional therapy of melasma suggesting the protective effect of stromal targeting therapy in melasma development. (Clinical Trial registration number: NCT05710068, date of first registration: 02/02/2023)