Comparing the efficacy of Micro-needling Alone versus Micro-needling with Topical 5-Fluorouracil in Treating Stable Non-Segmental Vitiligo

Background: Vitiligo is a commonly acquired, idiopathic, heritable white macule which increases in diameter with time due to melanocytes loss. Several treatment modalities, ranging from medical to surgical interference, are available. Many studies stated that inducing injury combined with topical 5Fluoro-uracil (5-FU) induces skin re-pigmentation in vitiligo lesions. Microneedling is a reasonably, inexpensive, easy and fast evaluating tool present in outpatient clinics as a trans-dermal drug delivery device for high molecular-weight drugs to enhance their absorption and effect.
Objectives: Evaluation of the efficacy of micro-needling plus topical 5-FU in treating stable non-segmental vitiligo and comparing its results with micro-needling alone. Patients and Methods: Fifty patients complaining of stable, non segmental vitiligo were recruited for our study, where we picked two patches; one patch was treated with micro-needling without adding any medicine, while we treated the other with micro-needling with 5‐FU added. The sessions were every 2 weeks, and each patient received 6 sessions in 3 months.
Results: On the micro-needling alone side, none (0%) of studied participants showed repigmentation, while in micro-needling with 5FU side, 38 (76%) of patients showed repigmentation response, out of which 23 cases (46.0%) had mild repigmentation (<25%) whereas the remaining 15 cases (30.0%) had moderate repigmentation (25-50%).
Conclusion: Micro-needling with 5-FU is considered a safe, easy, and tolerable procedure for vitiligo treatment.
Significance: Micro-needling and 5 Fluorouracil are well known treatments, used frequently in aesthetic and skin malignancy fields; can be helpful also in pigmentary problems by delivering the drug and creating an inflammatory environment also helping the transportation of melanocytes to the vitiliginous area.