Title : Efficacy of sylfirm x microneedling with radiofrequency alone versus combination treatment with a first session of chemical peel followed by sylfirm x in the treatment of resistant melasma: A pilot study.
Objectives: To compare the efficacy of Sylfirm X (microneedling with radiofrequency) alone with Sylfirm X combined with first session of Chemical Peel in the treatment of resistant melasma.
Study design: This comparative prospective study was conducted at the Skin Matters Clinic, Rawalpindi, Pakistan from Sept 25, 2020 to March 25, 2022.
Methodology: A total of 110 patients with melasma, 20 to 55 years of age, were included in this study. Patients with a history of discoid lupus erythematosus, pregnancy, lactation, anemia, and oral contraceptives or hormone replacement therapy were excluded from the study. Melasma Area severity index MASI tool was used to assess severity of Melasma at baseline and at end of 24 weeks in all patients completing study. Randomization was 1:1 for groups A and B, i.e. each upcoming patient was included in the next group. Sixty patients were placed in group A (Sylfirm X) and Sixty patients were enrolled in group B (Sylfirm X + Chemical Peel). Follow-up was done at three weekly intervals for a total 24 weeks, when the final response was assessed.
Results: In group A, the average age was 34 years, while in group B it was 33 years. Among the entire patients ie total of 220 patients, 88 were from group A and 132 were from group B. Chemical Peel used was Azelaic acid Peel followed by Sylfirm X after two weeks and then three weekly sessions of Sylfirm X for a total of four to six sessions depending on response. Fifty seven patients completed study in group A while 55 patients completed study in group B. Group A 46/57 showed reduction in MASI score in 80.70% patients whereas in group B, 46/55 (83.63%) patients showed marked reduction in MASI score.
Conclusion: This study concluded that the efficacy of Sylfirm X combined with first session of Chemical Peel is more effective than Sylfirm X (microneedling with radiofrequency) alone in the treatment of resistant melasma.