{"title":"Combining Microneedling and Tranexamic Acid for Melasma: A Systematic Review and Meta-Analysis.","authors":"Qixuan Wang, Chen Ma, Ling Zhang","doi":"10.1007/s00266-025-05043-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Tranexamic acid (TXA) has been explored as a potential treatment for melasma, and microneedling (MN) enhances transcutaneous drug delivery. To evaluate the clinical efficacy, patient satisfaction, and safety of microneedling combined with TXA (MN + TXA) in treating melasma compared to alternative treatment modalities.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines. Clinical improvement, patient satisfaction, and adverse events were analyzed using standardized mean differences (SMD) with 95% confidence intervals (CI). The risk of bias was assessed using the RoB 2.0 and ROBINS-I tools.</p><p><strong>Results: </strong>MN + TXA showed no significant improvement over other treatments in overall clinical outcomes. However, subgroup analysis revealed MN + TXA was significantly more effective than MN alone. Patient satisfaction did not significantly differ between MN + TXA and other treatments. The incidence of adverse events was similar across treatment groups.</p><p><strong>Conclusion: </strong>Compared to other therapies, MN+TXA may be considered a potential option for melasma management. Future large-scale, standardized, multicenter trials directly are essential to confirm its efficacy, safety, and clinical utility.</p><p><strong>Level of evidence i: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aesthetic Plastic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00266-025-05043-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Tranexamic acid (TXA) has been explored as a potential treatment for melasma, and microneedling (MN) enhances transcutaneous drug delivery. To evaluate the clinical efficacy, patient satisfaction, and safety of microneedling combined with TXA (MN + TXA) in treating melasma compared to alternative treatment modalities.
Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Clinical improvement, patient satisfaction, and adverse events were analyzed using standardized mean differences (SMD) with 95% confidence intervals (CI). The risk of bias was assessed using the RoB 2.0 and ROBINS-I tools.
Results: MN + TXA showed no significant improvement over other treatments in overall clinical outcomes. However, subgroup analysis revealed MN + TXA was significantly more effective than MN alone. Patient satisfaction did not significantly differ between MN + TXA and other treatments. The incidence of adverse events was similar across treatment groups.
Conclusion: Compared to other therapies, MN+TXA may be considered a potential option for melasma management. Future large-scale, standardized, multicenter trials directly are essential to confirm its efficacy, safety, and clinical utility.
Level of evidence i: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
期刊介绍：
Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP).
Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships.
Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.
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