Reviews
Vol. 17 No. 3 (2025)
The efficacy and safety of microneedling combined with tacrolimus versus tacrolimus monotherapy for vitiligo treatment: a systematic review and meta-analysis
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 21 February 2025
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Tacrolimus is a topical immunomodulator that has been used successfully in treating vitiligo; however, recent studies suggested that combining tacrolimus with microneedling (Mn) can increase its efficacy. This systematic review aimed to assess the efficacy and safety of Mn 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 Mn combined with tacrolimus (RR=2.02, 95% confidence interval [CI]: 1.51-2.70). Nonetheless, no significant difference was found between Mn combined with tacrolimus and tacrolimus monotherapy in terms of 5-grade repigmentation 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). Mn 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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How to Cite
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Maaddawi HA, Aljuaid AA, Alamri AM, Alghowairi DH, Bawazeer AS. The efficacy and safety of microneedling combined with tacrolimus versus tacrolimus monotherapy for vitiligo treatment: a systematic review and meta-analysis. Dermatol Reports [Internet]. 2025 Feb. 21 [cited 2026 May 26];17(3). Available from: https://journals.pagepress.net/dr/article/view/10166
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