Microneedling combined with irradiated human amniotic gel versus platelet-rich plasma in melasma: a split-face comparative study

Introduction Melasma is a chronic relapsing pigmentary disorder that poses a significant therapeutic challenge, prompting growing interest in regenerative treatment modalities such as platelet-rich plasma (PRP) and amniotic membrane-derived products. Objective To compare the efficacy and safety of microneedling with irradiated human amniotic gel (HAG) versus microneedling with PRP in melasma. Patients and methods In this split-face comparative interventional study thirty female participants with melasma were included. The right hemiface received microneedling combined with PRP, while the left side received microneedling combined with HAG. Participants received three treatment sessions spaced 4 weeks apart. Therapeutic effect was determined using the modified Melasma Area and Severity Index (mMASI), Wood’s lamp examination, and patient satisfaction scores. Results A highly significant reduction in mMASI scores was observed after treatment in both modalities ( P <0.001). Nevertheless, the side treated with PRP demonstrated significantly greater improvement compared with the HAG-treated side with higher reduction in mMASI scores and better patient satisfaction ( P <0.001). Both interventions were well tolerated, with only mild and transient adverse effects reported. No significant association was found between treatment response (regarding percentage of improvement of mMASI scores) with either age, disease duration, or baseline mMASI score ( P >0.05). Conclusion Microneedling combined with either irradiated HAG or PRP is safe and effective in melasma, with PRP showing superior clinical efficacy and patient satisfaction.