Evaluation of Microneedling, Platelet-Rich Plasma, and Combined Microneedling and Platelet-Rich Plasma in Treatment of Vitiligo

Abstract Background Vitiligo is an acquired pigmentary disorder resulting from loss of melanocytes which causes depigmentation of the skin. Clinically, it is characterized by the progressive loss of melanocytes causing the appearance of well-circumscribed milky white cutaneous macules and patches. Aim of the Work To evaluate and compare the efficacy and safety of microneedling, platelet rich plasma (PRP) and combined PRP and microneedling for patients with stable vitiligo. Patients and Methods This study is randomized clinical trial. It was conducted on 225 stable vitiligo lesions. All patients were selected from the dermatology outpatient vitiligo clinic of Ain Shams University hospital from November 2020 to May 2022. All subjects who participated in this study gave written informed consents. The study was approved by the research ethical committee of Ain Shams University and fulfilled all the ethical aspects required in human research. Results A significant reduction was demonstrated through vitiligo analysis by computer-assisted grid (VACAG) in microneedling group only than other. There was no or minimal side effects in microneedling group. Regardless of the modalities, better improvement was seen in the neck followed by the trunk then lower limbs and the least improvement was in the upper limp. Conclusion according to our study, microneedling achieved superior repigmentation than combined PRP and microneedling. However, PRP alone showed poor improvement. Microneedling could be used safely and effectively in treatment of refractory NSV.