Abstract

Background: Acupuncture shows benefits for patients with melasma, although no optimal number of sessions have been determined.Methods: The prospective observational study was conducted in melasma patients who were treated with acupuncture procedures two times a week and were evaluated after the 5th and the 10th sessions of acupuncture, with a 1-week follow-up after the last session. Participants Groups A and B received five and 10 acupuncture sessions, respectively. Melasma was assessed by using the melanin index (MI), melasma area and severity index (MASI), patient-reported improvement scores, and acupuncture-related adverse events.Results: Out of 113 participants, 67 received five sessions of acupuncture treatment while 39 received 10 sessions. At 1 week after five sessions of acupuncture in Group A, the mean MI decreased by 28.7 (95% CI −38.5 to −18.8, p < 0.001), whereas the median MASI decreased by 3.4 (95% CI −6.9 to −1.2, p < 0.001) points. At 1 week after ten sessions of acupuncture in Group B, the mean MI decreased by 31.3 (95% CI −45 to −17.6, p < 0.001), whereas the median MASI decreased by 5.4 (95%CI −9.9 to −3, p < 0.001) points. The first five sessions of acupuncture had a higher incremental effect than the last five sessions, although there was no statistically significant difference. Twenty-nine participants reported minor side effects. Group B had a risk ratio (RR) of having adverse events 1.8 times (95% CI 1.0–3.4, p = 0.05) compared with Group A.Conclusion: Short acupuncture regimens of 5–10 sessions in melasma seem to be effective and practical with minor side effects.

Highlights

  • Melasma is acquired hyperpigmentation characterized by ill-defined light to dark brownish macules and patches, typically affecting photo-exposed areas of the face [1,2,3]

  • Another randomized control trial (RCT) found that after the acupuncture treatment for melasma, blood estrogen level decreased while progesterone increased, which corresponds to the association of increasing estrogen and decreasing progesterone level in melasma patients [14]

  • Acupuncture for melasma has been shown to be effective at low cost with minimal side effects which is beneficial for this chronic recurrent skin disease

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Summary

Introduction

Melasma is acquired hyperpigmentation characterized by ill-defined light to dark brownish macules and patches, typically affecting photo-exposed areas of the face [1,2,3]. In Chinese medicine theory, acupuncture can promote blood and qi circulation, reducing blood stasis, rebalance and regulate various internal systems in the body to promote the metabolism of epidermal cells, as well as regulate several hormones and antioxidants improving the melasma [13, 16, 17]. Another randomized control trial (RCT) found that after the acupuncture treatment for melasma, blood estrogen level decreased while progesterone increased, which corresponds to the association of increasing estrogen and decreasing progesterone level in melasma patients [14]. Acupuncture shows benefits for patients with melasma, no optimal number of sessions have been determined

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