{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T14:14:11Z","timestamp":1793110451792,"version":"4.5.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T00:00:00Z","timestamp":1777075200000},"content-version":"vor","delay-in-days":114,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Jeisys Med Inc., Seoul, Republic of South Korea"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Melasma is a chronic, relapsing hyperpigmentation disorder that is difficult to treat, particularly in Fitzpatrick skin types III-V, where energy-based devices frequently induce postinflammatory hyperpigmentation (PIH). Radiofrequency microneedling (RFMN) has emerged as a promising alternative because it targets dermal pathology while minimizing epidermal injury. Systematically evaluate the efficacy, safety, and mechanistic rationale of RFMN for melasma. A PRISMA 2020 compliant search of PubMed, Embase, Cochrane CENTRAL, and LILACS (2014-2025) identified clinical studies evaluating RFMN alone or in combination therapies. Risk of bias was assessed using Joanna Briggs Institute tools. Owing to clinical and methodological heterogeneity, a qualitative synthesis was performed. Across 12 included studies, RFMN consistently improved Melasma Area and Severity Index (MASI) or modified MASI scores and melanin indices, with effects maintained up to 6 months. Histological evidence demonstrated reductions in dermal senescence markers and partial restoration of basement-membrane integrity. RFMN also showed a favorable safety profile, with a low incidence of PIH in darker phototypes. Combination treatment, particularly with low-fluence Q-switched Nd:YAG laser produced greater pigment reduction than monotherapy. RFMN is an effective and safe modality for melasma, offering advantages over pigment-directed lasers by addressing dermal mechanisms and limiting PIH risk. It may serve as a first-line energy-based therapy.<\/jats:p>\n                  <jats:p>Level of Evidence:3 (Therapeutic)<\/jats:p>\n                  <jats:p>For image description, please refer to the figure legend and surrounding text.<\/jats:p>","DOI":"10.1093\/asjof\/ojag075","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T11:41:09Z","timestamp":1776944469000},"source":"Crossref","is-referenced-by-count":3,"title":["The Efficacy and Safety of Radiofrequency Microneedling for Melasma: A Systematic Review and Qualitative Evidence Synthesis"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4911-9726","authenticated-orcid":false,"given":"Narendra","family":"Kumar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4249-6852","authenticated-orcid":false,"given":"Shangli","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6391-6348","authenticated-orcid":false,"given":"Amit","family":"Luthra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tejas","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2937-3129","authenticated-orcid":false,"given":"Ashish 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