Exploring the Effectiveness, Tolerability, and Safety of the Adjunctive Use of Microneedling With Tranexamic Acid in the Treatment of Melasma

This review compares microneedling-based TXA delivery with other treatment approaches, highlighting patient-centered advantages in tolerability and durability that may inform individualized treatment selection. Future studies should address limitations in protocol heterogeneity, reliance on semi-objective outcome measures, and limited long-term follow-up. Particular focus is needed on evaluating patients with skin of color, who may be more susceptible to post-inflammatory hyperpigmentation.