Abstract
INTRODUCTION: Melasma is a long-term acquired disorder characterized by symmetrical darkening in facial regions exposed to sunlight. Although some risk factors have been identified, the etiology remains unclear, and interventions frequently do not totally improve outcomes. AIM: It compares the efficacy and side effects of platelet-rich plasma therapy administered by microneedling versus microinjection to detect any difference in the delivery methods, treatment outcomes, and safety profiles. METHODS: In this prospective, single-center, randomized split-face research, 62 patients' melasma was treated with PRP therapy using microneedling versus microinjection. Microneedling and microinjection were used to apply PRP to the face's two sides. Photographs were obtained before therapy, and the modified Melasma Area and Severity Index (MASI), Physician Global Assessment, and Patient Global Assessment were used for monthly follow-up evaluation. In order to compare safety and efficacy, adverse events were recorded and statistical analysis was performed. RESULTS: A significantly significant difference (p < 0.001) was observed in the mean change in MASI score between microinjection and microneedling. The microneedling group showed a 73.33% improvement while the microinjection group had an 18.33% improvement, both of which were greater than 50%. The microneedling group showed a 46.67% improvement and the microinjection group had a 5% improvement of over 75%. There were no noteworthy negative effects observed. CONCLUSION: PRP therapy with microneedling is superior to microinjection in treating melasma; patients who receive microneedling show noticeably better improvement.