{"id":"https://openalex.org/W7203531241","doi":"https://doi.org/10.25122/jml-2026-0051","title":"Efficacy and safety of microneedling with tranexamic acid versus microneedling with vitamin C in the treatment of melasma: a systematic review and meta-analysis","display_name":"Efficacy and safety of microneedling with tranexamic acid versus microneedling with vitamin C in the treatment of melasma: a systematic review and meta-analysis","publication_year":2026,"publication_date":"2026-06-01","ids":{"openalex":"https://openalex.org/W7203531241","doi":"https://doi.org/10.25122/jml-2026-0051","pmid":"https://pubmed.ncbi.nlm.nih.gov/42602406","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13474404"},"language":"en","primary_location":{"id":"doi:10.25122/jml-2026-0051","doi":"https://doi.org/10.25122/jml-2026-0051","is_oa":true,"landing_page_url":"https://doi.org/10.25122/jml-2026-0051","pdf_url":"https://medandlife.org/wp-content/uploads/JMedLife-19-433.pdf","source":{"id":"https://openalex.org/S2755172410","display_name":"Journal of Medicine and Life","issn_l":"1844-122X","issn":["1844-122X","1844-3117"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","medline","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320337","host_organization_name":"Carol Davila University of Medicine and Pharmacy Publishing House","host_organization_lineage":["https://openalex.org/P4310320337"],"host_organization_lineage_names":["Carol Davila University of Medicine and Pharmacy Publishing House"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Medicine and Life","raw_type":"journal-article"},"volume":null,"type":"review","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://medandlife.org/wp-content/uploads/JMedLife-19-433.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5124314632","display_name":"Thanapon Roddaje","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I13590829","display_name":"Dhurakij Pundit University","ror":"https://ror.org/01k12f283","country_code":"TH","type":"education","lineage":["https://openalex.org/I13590829"]}],"countries":["TH"],"is_corresponding":true,"raw_author_name":"Thanapon Roddaje","raw_affiliation_strings":["College of Integrative Medicine, Dhurakij Pundit University, Bangkok, Thailand"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"College of Integrative Medicine, Dhurakij Pundit University, Bangkok, Thailand","institution_ids":["https://openalex.org/I13590829"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5147242885","display_name":"Sinitta Saowarat","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I13590829","display_name":"Dhurakij Pundit University","ror":"https://ror.org/01k12f283","country_code":"TH","type":"education","lineage":["https://openalex.org/I13590829"]}],"countries":["TH"],"is_corresponding":false,"raw_author_name":"Sinitta Saowarat","raw_affiliation_strings":["College of Integrative Medicine, Dhurakij Pundit University, Bangkok, Thailand"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"College of Integrative Medicine, Dhurakij Pundit University, Bangkok, Thailand","institution_ids":["https://openalex.org/I13590829"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5045184635","display_name":"Phawit Norchai","orcid":"https://orcid.org/0000-0001-9154-6524","observed_orcids":["https://orcid.org/0000-0001-9154-6524"]},"institutions":[{"id":"https://openalex.org/I13590829","display_name":"Dhurakij Pundit University","ror":"https://ror.org/01k12f283","country_code":"TH","type":"education","lineage":["https://openalex.org/I13590829"]}],"countries":["TH"],"is_corresponding":false,"raw_author_name":"Phawit Norchai","raw_affiliation_strings":["College of Integrative Medicine, Dhurakij Pundit University, Bangkok, Thailand"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"College of Integrative Medicine, Dhurakij Pundit University, Bangkok, Thailand","institution_ids":["https://openalex.org/I13590829"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5124314632"],"corresponding_institution_ids":["https://openalex.org/I13590829"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"19","issue":"6","first_page":"433","last_page":"444"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11172","display_name":"Dermatologic Treatments and Research","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2708","display_name":"Dermatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11172","display_name":"Dermatologic Treatments and Research","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2708","display_name":"Dermatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11144","display_name":"melanin and skin pigmentation","score":0.0,"subfield":{"id":"https://openalex.org/subfields/1307","display_name":"Cell Biology"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10704","display_name":"Advancements in Transdermal Drug Delivery","score":0.0,"subfield":{"id":"https://openalex.org/subfields/3003","display_name":"Pharmaceutical Science"},"field":{"id":"https://openalex.org/fields/30","display_name":"Pharmacology, Toxicology and Pharmaceutics"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/microneedling","display_name":"microneedling","score":0.921999990940094},{"id":"https://openalex.org/keywords/tranexamic-acid","display_name":"tranexamic acid","score":0.9909999966621399},{"id":"https://openalex.org/keywords/vitamin-c","display_name":"vitamin C","score":0.9940000176429749},{"id":"https://openalex.org/keywords/melasma","display_name":"melasma","score":0.9739999771118164},{"id":"https://openalex.org/keywords/skin-pigmentation","display_name":"skin pigmentation","score":0.6470000147819519},{"id":"https://openalex.org/keywords/masi","display_name":"MASI","score":0.5569999814033508},{"id":"https://openalex.org/keywords/treatment-efficacy","display_name":"treatment efficacy","score":0.6850000023841858},{"id":"https://openalex.org/keywords/tolerability","display_name":"tolerability","score":0.8500000238418579},{"id":"https://openalex.org/keywords/adverse-events","display_name":"adverse events","score":0.828000009059906},{"id":"https://openalex.org/keywords/transdermal-drug-delivery","display_name":"transdermal drug delivery","score":0.5289999842643738}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9135000109672546},{"id":"https://openalex.org/C2779637338","wikidata":"https://www.wikidata.org/wiki/Q418666","display_name":"Tranexamic acid","level":3,"score":0.8187000155448914},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.5656999945640564},{"id":"https://openalex.org/C205679159","wikidata":"https://www.wikidata.org/wiki/Q3375179","display_name":"Transdermal","level":2,"score":0.4584999978542328},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.44830000400543213},{"id":"https://openalex.org/C2780022331","wikidata":"https://www.wikidata.org/wiki/Q199678","display_name":"Vitamin C","level":2,"score":0.3885999917984009},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.31769999861717224},{"id":"https://openalex.org/C2776940978","wikidata":"https://www.wikidata.org/wiki/Q34956","display_name":"Vitamin","level":2,"score":0.2994000017642975},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2833999991416931},{"id":"https://openalex.org/C42404028","wikidata":"https://www.wikidata.org/wiki/Q864940","display_name":"Bioequivalence","level":3,"score":0.2815000116825104},{"id":"https://openalex.org/C2986274086","wikidata":"https://www.wikidata.org/wiki/Q199678","display_name":"Ascorbic acid","level":2,"score":0.28040000796318054},{"id":"https://openalex.org/C67774102","wikidata":"https://www.wikidata.org/wiki/Q614132","display_name":"Number needed to treat","level":4,"score":0.2750000059604645},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.2703999876976013},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.2648000121116638},{"id":"https://openalex.org/C126894567","wikidata":"https://www.wikidata.org/wiki/Q105650","display_name":"Urology","level":1,"score":0.26350000500679016},{"id":"https://openalex.org/C189708586","wikidata":"https://www.wikidata.org/wiki/Q1504425","display_name":"Systematic review","level":3,"score":0.2632000148296356},{"id":"https://openalex.org/C2993590494","wikidata":"https://www.wikidata.org/wiki/Q182338","display_name":"Vitamin k","level":2,"score":0.26159998774528503},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.2612999975681305},{"id":"https://openalex.org/C3018260909","wikidata":"https://www.wikidata.org/wiki/Q1322871","display_name":"Exploratory analysis","level":2,"score":0.260699987411499},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.26030001044273376},{"id":"https://openalex.org/C3018359032","wikidata":"https://www.wikidata.org/wiki/Q1550789","display_name":"Safety profile","level":3,"score":0.25859999656677246}],"mesh":[{"descriptor_ui":"D000097244","descriptor_name":"Percutaneous Collagen Induction","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000099098","descriptor_name":"Microneedle Drug Delivery","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001205","descriptor_name":"Ascorbic Acid","qualifier_ui":"Q000008","qualifier_name":"administration & dosage","is_major_topic":true},{"descriptor_ui":"D001205","descriptor_name":"Ascorbic Acid","qualifier_ui":"Q000009","qualifier_name":"adverse effects","is_major_topic":true},{"descriptor_ui":"D001205","descriptor_name":"Ascorbic Acid","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008548","descriptor_name":"Melanosis","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":true},{"descriptor_ui":"D008548","descriptor_name":"Melanosis","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D009339","descriptor_name":"Needles","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014148","descriptor_name":"Tranexamic Acid","qualifier_ui":"Q000008","qualifier_name":"administration & dosage","is_major_topic":true},{"descriptor_ui":"D014148","descriptor_name":"Tranexamic Acid","qualifier_ui":"Q000009","qualifier_name":"adverse effects","is_major_topic":true},{"descriptor_ui":"D014148","descriptor_name":"Tranexamic Acid","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true},{"descriptor_ui":"D016896","descriptor_name":"Treatment Outcome","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":3,"locations":[{"id":"doi:10.25122/jml-2026-0051","doi":"https://doi.org/10.25122/jml-2026-0051","is_oa":true,"landing_page_url":"https://doi.org/10.25122/jml-2026-0051","pdf_url":"https://medandlife.org/wp-content/uploads/JMedLife-19-433.pdf","source":{"id":"https://openalex.org/S2755172410","display_name":"Journal of Medicine and Life","issn_l":"1844-122X","issn":["1844-122X","1844-3117"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","medline","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320337","host_organization_name":"Carol Davila University of Medicine and Pharmacy Publishing House","host_organization_lineage":["https://openalex.org/P4310320337"],"host_organization_lineage_names":["Carol Davila University of Medicine and Pharmacy Publishing House"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Medicine and Life","raw_type":"journal-article"},{"id":"pmid:42602406","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42602406","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of medicine and life","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13474404","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13474404/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"J Med Life","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.25122/jml-2026-0051","doi":"https://doi.org/10.25122/jml-2026-0051","is_oa":true,"landing_page_url":"https://doi.org/10.25122/jml-2026-0051","pdf_url":"https://medandlife.org/wp-content/uploads/JMedLife-19-433.pdf","source":{"id":"https://openalex.org/S2755172410","display_name":"Journal of Medicine and Life","issn_l":"1844-122X","issn":["1844-122X","1844-3117"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","medline","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320337","host_organization_name":"Carol Davila University of Medicine and Pharmacy Publishing House","host_organization_lineage":["https://openalex.org/P4310320337"],"host_organization_lineage_names":["Carol Davila University of Medicine and Pharmacy Publishing House"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Medicine and Life","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9922999739646912,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Systematic Review","id":"https://openalex.org/study-designs/systematic-review"},{"display_name":"Meta-Analysis","id":"https://openalex.org/study-designs/meta-analysis"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7203531241.pdf","grobid_xml":"https://content.openalex.org/works/W7203531241.grobid-xml"},"referenced_works_count":17,"referenced_works":["https://openalex.org/W2011381935","https://openalex.org/W2064753339","https://openalex.org/W2071889856","https://openalex.org/W2738306014","https://openalex.org/W2954729314","https://openalex.org/W3119865832","https://openalex.org/W3154657415","https://openalex.org/W3158588323","https://openalex.org/W3211293861","https://openalex.org/W4224433987","https://openalex.org/W4387825639","https://openalex.org/W4396598866","https://openalex.org/W4402377509","https://openalex.org/W4409288316","https://openalex.org/W4410490003","https://openalex.org/W4411433133","https://openalex.org/W7134845991"],"related_works":["https://openalex.org/W2954729314","https://openalex.org/W4387825639","https://openalex.org/W3211293861","https://openalex.org/W4385850874","https://openalex.org/W7167495413","https://openalex.org/W3119865832","https://openalex.org/W4224433987","https://openalex.org/W4411433133","https://openalex.org/W4413871353","https://openalex.org/W2007052400"],"abstract_inverted_index":{"This":[0],"study":[1,115],"aimed":[2],"to":[3,102,240],"compare":[4],"the":[5,136,178,222],"efficacy":[6],"and":[7,24,43,60,93,117,129,151,158,187,237],"short-term":[8,194],"tolerability":[9],"of":[10,41,180,208,227,232],"microneedling":[11,113,188],"combined":[12],"with":[13,70,148,185,189,204,219],"either":[14],"tranexamic":[15,91],"acid":[16,92],"or":[17],"vitamin":[18,94,190],"C":[19,95,191],"for":[20,213],"melasma.A":[21],"systematic":[22],"review":[23],"meta-analysis":[25],"following":[26],"PRISMA":[27],"2020":[28],"guidelines":[29],"was":[30],"conducted":[31],"across":[32,57],"five":[33],"databases":[34],"(MEDLINE,":[35],"Google":[36],"Scholar,":[37],"EBSCO,":[38],"ProQuest,":[39],"Web":[40],"Science)":[42],"ClinicalTrials.gov(2015)(2016)(2017)(2018)(2019)(2020)(2021)(2022)(2023)(2024)(2025).Eight":[44],"studies":[45],"(232":[46],"patients)":[47],"were":[48,55,127],"synthesized":[49],"using":[50,62],"a":[51,123,181,205],"random-effects":[52],"model;":[53],"outcomes":[54,195],"harmonized":[56],"MASI,":[58],"mMASI,":[59],"hemi-MASI":[61],"Hedges'":[63],"g":[64,97],"calculated":[65],"from":[66,165],"within-group":[67],"changefrom-baseline":[68],"scores,":[69],"an":[71],"imputed":[72],"within-person":[73],"correlation":[74],"(r":[75],"=":[76,98,105,108],"0.5;":[77],"sensitivity":[78],"range":[79],"0.25-0.75)for":[80],"split-face":[81,228],"designs.The":[82],"pooled":[83,170],"analysis":[84],"showed":[85,192],"no":[86],"statistically":[87],"significant":[88,124],"difference":[89,171],"between":[90],"(Hedges'":[96],"-0.123;95%":[99],"CI,":[100],"-0.311":[101],"0.065;":[103],"P":[104],"0.201;":[106],"I\u00b2":[107],"0.0%).Exploratory":[109],"subgroup":[110],"analyses":[111],"by":[112],"depth,":[114],"design,":[116],"follow-up":[118,138],"duration":[119],"did":[120],"not":[121,131,173],"detect":[122,241],"interaction":[125],"but":[126],"underpowered":[128],"should":[130,216],"be":[132,163,217],"interpreted":[133,218],"as":[134],"confirmatory.Within":[135],"short":[137],"windows":[139],"reported":[140],"(6-16":[141],"weeks),":[142],"both":[143],"interventions":[144],"appeared":[145],"well":[146],"tolerated,":[147],"only":[149],"mild":[150],"transient":[152],"adverse":[153],"events;":[154],"long-term":[155],"safety,":[156],"recurrence,":[157],"delayed":[159],"pigmentary":[160],"complications":[161],"cannot":[162],"characterized":[164],"this":[166,197],"evidence":[167,199],"base.A":[168],"non-significant":[169],"does":[172],"establish":[174],"therapeutic":[175],"equivalence":[176],"in":[177,234],"absence":[179],"pre-specified":[182],"non-inferiority":[183],"margin.Microneedling":[184],"TXA":[186],"comparable":[193],"within":[196],"limited":[198,238],"base.Available":[200],"data":[201],"are":[202],"compatible":[203],"needle":[206],"depth":[207],"\u22641.5":[209],"mm":[210],"being":[211],"adequate":[212],"transdermal":[214],"delivery.Findings":[215],"caution":[220],"given":[221],"modest":[223],"sample":[224],"size,":[225],"predominance":[226],"designs,":[229],"moderate":[230],"risk":[231],"bias":[233],"non-randomized":[235],"studies,":[236],"power":[239],"publication":[242],"bias.":[243]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-08-16T00:00:00"}
