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Published on: January 19, 2024
Clinical Effects and Safety of Radiofrequency Microneedling for the Management of Melasma: A Retrospective Study
Background:
Melasma is a chronic hyperpigmentary disorder that is difficult to treat in patients with Fitzpatrick phototypes III to VI because of the risk of postinflammatory hyperpigmentation. Radiofrequency microneedling (RFMN) is an emerging modality that targets dermal photoaging while minimizing epidermal injury.
Objectives:
The aim of this study was to evaluate the clinical effectiveness and safety of POTENZA RFMN in patients with melasma in a real-world retrospective cohort.
Methods:
The authors conducted a retrospective pre-post observational study of adults with clinically diagnosed melasma treated with POTENZA (Jeisys Medical Inc., Seoul, Republic of Korea) at a tertiary dermatology center in Seoul, Republic of Korea, between May 2022 and May 2025. All treatments were delivered in bipolar mode at 1 MHz with an insulated microneedle tip (I-25 or I-49). The primary outcome was the change in modified Melasma Area and Severity Index (mMASI) from baseline to posttreatment. Secondary outcomes included physician-rated improvement, patient satisfaction, changes in texture and brightness, and adverse events. Sensitivity analyses were performed to assess the robustness of the findings after excluding patients who received concurrent topical depigmenting agents.
Results:
Fifty patients (mean age 40.7 years; 60% female; Fitzpatrick type III in 80%) were included. Median (interquartile range) mMASI decreased from 6.15 (4.90-8.62) to 3.75 (2.18-5.92) (median ΔmMASI -1.80; median percentage reduction 32.3%; P < .001). A responder analysis using a ≥30% mMASI reduction threshold identified 27/50 patients (54%) as responders. No significant differences in ΔmMASI were observed by melasma pattern or Fitzpatrick phototype; however, male patients showed greater median improvement than female patients (-2.70 vs -1.65; P = .039). In the sunscreen-only subgroup (n = 31, functional monotherapy), the median percentage mMASI reduction was 42.3%, consistent with the overall cohort. Independent reviewers rated clinical improvement in 98% of patients (36% marked, 36% moderate, and 26% slight), and 90% of patients reported satisfaction. Procedure-related adverse events occurred in 12% of cases; all were mild, transient, and resolved without intervention.
Conclusions:
POTENZA RFMN produced clinically meaningful mMASI reductions, high physician-rated improvement, high patient satisfaction, and a favorable safety profile in this predominantly Fitzpatrick type III cohort of patients with mild-to-moderate melasma. These findings support RFMN as a promising adjunctive option and warrant confirmation in prospective controlled trials.
Level Of Evidence 4 Risk:
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Insights
Radiofrequency microneedling (RFMN) effectively treated melasma in Fitzpatrick skin types III-VI, showing significant improvement in the modified Melasma Area and Severity Index (mMASI) with high patient satisfaction and a good safety profile.
Area of Science:
- Dermatology
- Aesthetic Medicine
- Skin Treatments
Background:
- Melasma is a challenging hyperpigmentation disorder, particularly in darker skin tones (Fitzpatrick types III-VI), due to the risk of post-inflammatory hyperpigmentation.
- Radiofrequency microneedling (RFMN) is an innovative treatment that addresses dermal aging while minimizing epidermal damage, making it a potential option for melasma.
Purpose of the Study:
- To assess the clinical effectiveness and safety of POTENZA RFMN for treating melasma in a real-world setting.
- To evaluate changes in melasma severity, patient satisfaction, and adverse events following RFMN treatment.
Main Methods:
- A retrospective observational study involving adults diagnosed with melasma treated with POTENZA RFMN.
- Primary outcome measured by the change in the modified Melasma Area and Severity Index (mMASI) from baseline to post-treatment.
- Secondary outcomes included physician and patient assessments of improvement, skin texture/brightness, and adverse events.
Main Results:
- A significant reduction in median mMASI was observed (32.3% decrease, P < .001), with 54% of patients achieving ≥30% improvement.
- Physician-rated improvement was noted in 98% of patients, and 90% reported satisfaction.
- Adverse events were mild and transient in 12% of cases, with no significant differences based on melasma pattern or Fitzpatrick type.
Conclusions:
- POTENZA RFMN demonstrated clinically significant melasma improvement, high patient satisfaction, and a favorable safety profile in Fitzpatrick type III patients.
- RFMN shows promise as an adjunctive therapy for mild-to-moderate melasma.
- Further confirmation through prospective controlled trials is warranted.
