Comparative Study Between the Efficacy of Microneedling Combined with Trichloroacetic Acid Versus Microneedling with Tacrolimus in the Treatment of Stable Vitiligo

Background: Many treatment options were used for Vitiligo. But there is no consensus on the precise treatment modality. Aim of the work: The study aimed to assess and compare the efficacy of microneedling combined with trichloracetic acid [TCA] versus micro-needling with tacrolimus in the treatment of Vitiligo, Patients and Methods: 60 Vitiligo were included and classified into two equal groups. Group [A] included 30 patients who received micro-needling with dermapen then tacrolimus 0.03 ointments every two weeks for six sessions. Group B included thirty patients who received micro-needling with dermapen then TCA 25% every two weeks for six sessions. The outcome was documented. Results: The repigmentation was slightly higher in TCA-treated patches than with tacrolimus. Excellent response in repigmentation occurred in 43.3%of TCA patches. In contrast, in 16.7% of tacrolimus-treated patches, Good improvement occurred in13.3% of TCA-treated patches while 23.3% of tacrolimus-treated patches. Moderate improvement occurred in10.0% TCA -treated patches while 30.0% of tacrolimus-treated patches, mild improvement occurred in 13.3% of TCA -treated patches. In comparison, only in 16.7% of tacrolimus-treated patches, However, there was a great difference between the two drugs regarding erythema, inflammation, and exfoliations, which occurred mainly with TCA.Conclusion: The mix of microneedling with either TCA 25% or tacrolimus is effective and safe in treating Vitiligo. However, TCA achieved a slightly increased percentage of repigmentation than tacrolimus.