Sponge spicule for pigmentary dermatosis

For melasma, microneedling with transdermal drug action is superior to phototherapy. Budamakuntla treated 60 patients with moderate to severe melasma with tranexamic acid, divided into microdrip (single needle subcutaneous injection) and microneedling groups, and after 3 courses of treatment (total of 3 months), the improvement of melasma was measured using the Melasma Area and Severity Index (MASI) score. Severity Index (MASI) scores, only 26% of the patients in the former group showed an improvement of more than 50%, while 41% of the patients in the latter group showed an improvement of more than 50%, with a significant difference between the two groups (P < 0.001). Combination therapy is more recommended in the treatment of melasma. In a retrospective study of 22 patients with recalcitrant melasma (poorly treated with topical sunscreen and depigmenting agents), microneedling in combination with topical nighttime topical 0.05% retinoic acid, 4% hydroquinone, 1% florbetapir trometamol acetate, and daily use of sunscreen (spf60) was shown to be effective in all patients.