Platelet-rich plasma is a useful therapeutic option in melasma.

Background: Melasma is a cosmetically disfiguring disorder of facial pigmentation. Objectives: We evaluated the value of platelet-rich plasma (PRP) in the treatment of melasma using two different delivery techniques: microneedling using dermapen versus microinjections using mesoneedles. Patients and methods: Twenty-three adult Egyptian melasma patients were enrolled. Wood's light was used to determine the histological type of melasma. Autologous PRP was delivered into the lesional melasma skins through microneedling with dermapen on the right side of the face and intradermal microinjections using mesoneedles on the left side of the face (for each patient). The treatment was done regularly (three sessions, each month). The response to PRP therapy was measured using melasma area and severity index (MASI) and modified melasma area and severity index (mMASI) that were calculated before and after three treatment sessions. Hemi-MASI was used to compare the effectiveness of the two delivery techniques. Results: Following PRP treatment, MASI and mMASI scores decreased significantly from 11.86 ± 5.25 to 6.96 ± 4.82, and from 5.71 ± 2.56 to 2.90 ± 2.05, respectively ( p  < .000,). A statistically significant decrease was noted in the hemi-MASI score on each side of the face following PRP treatment ( p  < .000), but there was no significant difference in comparing both sides. Conclusions: Our study provides the first indication about the value of PRP as a useful and new therapeutic option in melasma. Moreover, our study was the first to compare PRP delivery through microneedling versus microinjections.