摘要

Objectives: To evaluate the efficacy of a novel microinvasive treatment for melasma using spicule-mediated delivery in combination with topical agents. To enhance pigment reduction and skin regeneration by improving transdermal delivery and addressing the root causes of dermal pigmentation recurrence. Introduction: Melasma is a chronic, relapsing pigmentation disorder caused by UV-stimulated tyrosinase activity and basement membrane damage due to MMP-driven collagen degradation. Conventional treatments like lasers and peels reduce surface pigment but often fail to resolve deeper structural damage, resulting in high relapse rates and limited durability. Materials / method: Spicule-mediated delivery uses 16 μm mineral spicules to create approximately 1.5 million microchannels per session, allowing signal peptides to reach the papillary dermis. These peptides, activated by glutathione, stimulate collagen regeneration. A topical booster containing tranexamic acid, glutathione, and exosomes was applied immediately post-treatment. Results: Clinical results showed that combining spicule-mediated delivery with a topical booster achieved up to 182% greater pigment reduction compared to spicules alone. The synergistic method enhanced melanin clearance, supported basement membrane repair, and improved epidermal renewal, offering superior clinical outcomes in melasma management. Conclusion: Spicule-mediated delivery presents a safe, non-invasive alternative for treating melasma. When combined with active topical agents, it targets both pigment formation and structural damage, offering a comprehensive and long-lasting solution for pigment reduction and skin health restoration.