{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T13:10:45Z","timestamp":1792242645408,"version":"4.4.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National Research Centre Egypt"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Med Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Melasma is a common, relapsing hyperpigmentation disorder with limited long-term treatment success. Recent advances suggest that microneedling may enhance the transdermal delivery and efficacy of topical agents. This study compares the clinical outcomes of microneedling-assisted delivery of topical metformin and tranexamic acid (TXA) in the treatment of facial melasma, with modified Kligman\u2019s formula as a control.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>To evaluate and compare the efficacy, safety, and patient satisfaction of microneedling with topical metformin versus TXA in melasma patients. Methods: Forty-five female patients with facial melasma were randomized into three equal groups. Group A received microneedling with topical metformin; Group B received microneedling with topical TXA; Group C applied modified Kligman\u2019s formula nightly. Treatments were conducted over 8\u00a0weeks. Outcomes included changes in modified Melasma Area and Severity Index (mMASI), patient satisfaction scores, pain levels, and adverse events. Results: All groups showed significant mMASI reductions. Group B achieved the greatest reduction (mean 45.3%) followed by Group C (38.2%) and Group A (22.1%) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Satisfaction scores were highest in Group B, with 33.3% reporting marked improvement. Minimal adverse events were reported across all groups, with no serious side effects. Pain scores were comparable between microneedling groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Microneedling with topical TXA demonstrated superior efficacy and patient satisfaction compared to metformin and Kligman\u2019s formula. While topical metformin showed some potential, its formulation and clinical utility require further study. Microneedling offers a promising approach to improve treatment outcomes in melisma.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1186\/s40001-025-03032-1","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T06:14:37Z","timestamp":1755497677000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Microneedling-assisted delivery of metformin versus tranexamic acid in treating melasma: a randomized controlled study"],"prefix":"10.1186","volume":"30","author":[{"given":"Abdelshakour","family":"Al Mohammady","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed S.","family":"Kadah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed A.","family":"Mahran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7541-5241","authenticated-orcid":false,"given":"Mohamed L.","family":"Elsaie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"issue":"3","key":"3032_CR1","first-page":"90","volume":"43","author":"SMA Ibrahim","year":"2025","unstructured":"Ibrahim SMA, Elsaie ML, Fusco I, Zingoni T, Rageh MA. 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Written informed consents were received from participants or their guardians upon explanation of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent to publish declaration for photos was obtained from guardians and parents.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"761"}}