The efficacy and safety of micro-needling combined with tacrolimus <i>versus</i> tacrolimus monotherapy for vitiligo treatment: a systematic review and meta-analysis

Tacrolimus is a topical immunomodulator that has been used successfully in treating vitiligo; however, recent studies suggested that combining tacrolimus with micro-needling can increase its efficacy. This systematic review aimed to assess the efficacy and safety of micro-needling combined with tac...

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Main Authors: Hadeel A. Maaddawi, Abdulaziz A. Aljuaid, Awadh M. Alamri, Dhaifallah H. Alghowairi, Abdullah S. Bawazeer
Format: Article
Language:English
Published: PAGEPress Publications 2025-02-01
Series:Dermatology Reports
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Online Access:https://www.pagepress.org/journals/dr/article/view/10166
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author Hadeel A. Maaddawi
Abdulaziz A. Aljuaid
Awadh M. Alamri
Dhaifallah H. Alghowairi
Abdullah S. Bawazeer
author_facet Hadeel A. Maaddawi
Abdulaziz A. Aljuaid
Awadh M. Alamri
Dhaifallah H. Alghowairi
Abdullah S. Bawazeer
author_sort Hadeel A. Maaddawi
collection DOAJ
description Tacrolimus is a topical immunomodulator that has been used successfully in treating vitiligo; however, recent studies suggested that combining tacrolimus with micro-needling can increase its efficacy. This systematic review aimed to assess the efficacy and safety of micro-needling combined with tacrolimus to treat localized and stable nonsegmental vitiligo. We searched Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). The risk ratio (RR) was used to represent dichotomous outcomes, whereas the odds ratio (OR) was used for adverse events. Three randomized control trials (RCTs) (n=148 participants) were deemed eligible. The pooled effect estimate showed a statistically significant higher re-pigmentation rate in all assessed body areas in favor of treatment with micro-needling combined with tacrolimus (RR=2.02, 95% CI: 1.51-2.70). Nonetheless, no significant difference was found between micro-needling combined with tacrolimus and tacrolimus monotherapy in terms of 5-grade re-pigmentation scale (RR=0.93, 95% CI: 0.53-1.62), histopathological assessment (RR=0.90, 95% CI 0.47-1.75), and adverse events (OR: 1.72, 95% CI: 0.10-29.36). The number of included studies is low, with a relatively low sample size. Micro-needling combined with tacrolimus showed a clinically and statistically substantial improvement in the re-pigmentation of vitiligo sites with acceptable tolerability and safety profile.
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spelling doaj-art-bdf67839265646bfb098c9135ff2a7ef2025-08-20T02:14:50ZengPAGEPress PublicationsDermatology Reports2036-73922036-74062025-02-0110.4081/dr.2025.10166The efficacy and safety of micro-needling combined with tacrolimus <i>versus</i> tacrolimus monotherapy for vitiligo treatment: a systematic review and meta-analysisHadeel A. Maaddawi0Abdulaziz A. Aljuaid1Awadh M. Alamri 2Dhaifallah H. Alghowairi3Abdullah S. Bawazeer4Department of Dermatology, College of Medicine, King Saud University, RiyadhCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah; King Abdullah International Medical Research Center, JeddahKing Abdullah International Medical Research Center, Jeddah; Department of Dermatology, King Abdulaziz Medical City, Jeddah; Assistant professor, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, JeddahDermatology consultant, Ministry of Defence, RiyadhHistopathology consultant, Ministry of Defence, Riyadh Tacrolimus is a topical immunomodulator that has been used successfully in treating vitiligo; however, recent studies suggested that combining tacrolimus with micro-needling can increase its efficacy. This systematic review aimed to assess the efficacy and safety of micro-needling combined with tacrolimus to treat localized and stable nonsegmental vitiligo. We searched Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). The risk ratio (RR) was used to represent dichotomous outcomes, whereas the odds ratio (OR) was used for adverse events. Three randomized control trials (RCTs) (n=148 participants) were deemed eligible. The pooled effect estimate showed a statistically significant higher re-pigmentation rate in all assessed body areas in favor of treatment with micro-needling combined with tacrolimus (RR=2.02, 95% CI: 1.51-2.70). Nonetheless, no significant difference was found between micro-needling combined with tacrolimus and tacrolimus monotherapy in terms of 5-grade re-pigmentation scale (RR=0.93, 95% CI: 0.53-1.62), histopathological assessment (RR=0.90, 95% CI 0.47-1.75), and adverse events (OR: 1.72, 95% CI: 0.10-29.36). The number of included studies is low, with a relatively low sample size. Micro-needling combined with tacrolimus showed a clinically and statistically substantial improvement in the re-pigmentation of vitiligo sites with acceptable tolerability and safety profile. https://www.pagepress.org/journals/dr/article/view/10166Vitiligomicro-needlingtacrolimus5-grade re-pigmentation scalePhysician's Global Assessmenthistopathological assessment
spellingShingle Hadeel A. Maaddawi
Abdulaziz A. Aljuaid
Awadh M. Alamri
Dhaifallah H. Alghowairi
Abdullah S. Bawazeer
The efficacy and safety of micro-needling combined with tacrolimus <i>versus</i> tacrolimus monotherapy for vitiligo treatment: a systematic review and meta-analysis
Dermatology Reports
Vitiligo
micro-needling
tacrolimus
5-grade re-pigmentation scale
Physician's Global Assessment
histopathological assessment
title The efficacy and safety of micro-needling combined with tacrolimus <i>versus</i> tacrolimus monotherapy for vitiligo treatment: a systematic review and meta-analysis
title_full The efficacy and safety of micro-needling combined with tacrolimus <i>versus</i> tacrolimus monotherapy for vitiligo treatment: a systematic review and meta-analysis
title_fullStr The efficacy and safety of micro-needling combined with tacrolimus <i>versus</i> tacrolimus monotherapy for vitiligo treatment: a systematic review and meta-analysis
title_full_unstemmed The efficacy and safety of micro-needling combined with tacrolimus <i>versus</i> tacrolimus monotherapy for vitiligo treatment: a systematic review and meta-analysis
title_short The efficacy and safety of micro-needling combined with tacrolimus <i>versus</i> tacrolimus monotherapy for vitiligo treatment: a systematic review and meta-analysis
title_sort efficacy and safety of micro needling combined with tacrolimus i versus i tacrolimus monotherapy for vitiligo treatment a systematic review and meta analysis
topic Vitiligo
micro-needling
tacrolimus
5-grade re-pigmentation scale
Physician's Global Assessment
histopathological assessment
url https://www.pagepress.org/journals/dr/article/view/10166
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