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Updated: Jul 14, 2026
Author Spotlight: Non-Surgical Treatment of Melasma– Microneedling with Tranexamic Acid
Published on: January 19, 2024
Combining Microneedling and Tranexamic Acid for Melasma: A Systematic Review and Meta-Analysis
Qixuan Wang1, Chen Ma1, Ling Zhang2
1Laser Aesthetic Center, Plastic Surgery Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 33, Badachu Road, Shijingshan District, Beijing, China.
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 .
