A Retrospective Analysis of Radiofrequency Microneedling for Melasma Management in the Japanese Population

Background: Melasma is a chronic pigmentary disorder with multifactorial pathogenesis and significant psychosocial impact. Although radiofrequency microneedling has emerged as a dermal-targeting adjunctive therapy, real-world evidence regarding its clinical effects and safety is limited. Objective: radiofrequency microneedling for melasma treatment. Methods: radiofrequency microneedling treatment were included in the analysis. Melasma severity was assessed using the modified Melasma Area and Severity Index (mMASI) score. Patient-reported satisfaction, qualitative clinical improvement, and adverse events were analyzed descriptively. Results: A total of 29 female patients (mean age, 45.2 ± 7.9 years) were included in the study. The median baseline mMASI score was 6 (IQR 4-12) and remained 6 (IQR 4-8) after treatment, with no statistically significant difference between the time points (p = 0.16). Overall, 26 patients (89.7%) demonstrated stable or improved mMASI scores post procedure. Percentage-based analyses showed substantial interindividual variability: 27.6% of patients achieved≥25% and ≥30% reductions in mMASI, and 10.3% achieved≥50% reduction. Patient satisfaction was reported in 62.1% of the cases. All patients experienced mild, transient erythema that resolved without sequelae, and no serious adverse events were observed. Conclusion: radiofrequency microneedling demonstrated a favorable safety profile and provided clinically meaningful improvements in selected patients, supporting its role as a complementary treatment in multimodal melasma management.