Microneedling in Localized Acquired Hypomelanosis: A Randomized Controlled Trial

BACKGROUND Several insults can cause acquired localized hypomelanosis which can be a therapeutic challenge. Microneedling is a minimally invasive procedure that stimulates melanogenesis with the benefit of short downtime and a low risk of scarring. OBJECTIVE To determine the efficacy and safety of microneedling in localized acquired hypomelanosis. MATERIALS AND METHODS This is a randomized controlled trial. Twenty patients aged 18 years and older had their lesions randomized into either a single session of microneedling with 1.5-mm needles or no treatment. Three months later, peripheral tanning, patient satisfaction, surface tanning grade of improvement, Vitiligo Extent Score for a Target Area (VESTA), patient and physician global assessment of improvement (GAI) were evaluated. RESULTS Median peripheral tanning was observed in 80% of lesions in the microneedling arm versus 85% in the no-treatment arm. Median physician GAI was 37.5% versus 33.33%, respectively. Median VESTA was 37.5% versus 29%, respectively. Median Patient GAI was 50% in both arms. Surface tanning showed a median increase of +3 grades in both arms. CONCLUSION Medium-depth microneedling deserves a place in the armamentarium of therapeutic tools for localized acquired hypomelanosis in normal-texture and scarred skin. The authors suggest repetitive sessions at intervals of 1 to 2 months to offer better coverage. Interestingly, a possible systemic effect of microneedling deserves further investigation.