Topical Epidermal Growth Factor with Microneedling in Melasma Treatment

Background: Melasma is a chronic, acquired hyperpigmentation of sun-exposed areas of the skin, influenced by genetic and environmental factors. Epidermal growth factor (EGF) has both mitogenic and depigmenting properties, but its efficacy is limited by poor skin penetration. Aim: This study investigated the effectiveness of combining topical EGF with Dermapen microneedling for the treatment of melasma. Methods: An interventional pre-and-post study was conducted at the Dermatology Outpatient Clinics of Suez Canal University Hospitals between May 2022 and January 2023. Twenty-four female patients aged 18–50 years with clinically and dermoscopically confirmed facial melasma were enrolled. Patients received three sessions of topical EGF applied with microneedling at four-week intervals. The modified Melasma Area and Severity Index (mMASI) was assessed at baseline, each visit, and three months after the first session. Digital photography, and patient self-evaluation were also performed. Results: Results: The mean age of patients was 36.71 ± 6.07 years. Most participants had skin type IV and centrofacial melasma. Major risk factors included a family history of melasma and the use of oral contraceptives. The mean baseline mMASI score decreased significantly from 7.97 ± 3.9 to 3.7 ± 3.9 at final follow-up (p < 0.05). Half of the patients reported being satisfied with their outcomes, while 20.8% were not satisfied. Dermoscopic and photographic assessments supported these findings, showing visible improvement and no recurrence during follow-up. Conclusion: Topical EGF delivered via microneedling is a promising adjuvant therapy for melasma but larger controlled trials are required