Efficacy of the Combination Therapy of Intense Pulsed Light and Microneedling With a Postbiotic Formulation for Melasma.

BACKGROUND: Melasma pathogenesis involves multifactorial mechanisms, and a comprehensive strategy achieves superior outcomes compared to monotherapy. Intense pulsed light (IPL) reduces pigmentation via selective photothermal effects, while microneedling enhances melanin clearance through mechanical stimulation and improves transdermal drug delivery. However, the therapeutic synergy of combining IPL with microneedling for melasma management requires further validation. OBJECTIVE: To assess the clinical effectiveness of combining IPL and microneedling with a postbiotic formulation containing Lactobacillus fermentation lysate in facial melasma. METHODS: Thirty individuals were enlisted and randomly split into two groups. IPL therapy group: Received IPL treatments at 4-week intervals for 12 weeks. Combination therapy group: Underwent alternating IPL and microneedling every 2 weeks for 12 weeks. Symptomatic improvement was assessed utilizing the Modified Melasma Area and Severity Index (mMASI) Score and VISIA skin detection system (Canfield, USA). Patient satisfaction was evaluated through questionnaires. RESULTS: Both groups showed significant mMASI score reductions from baseline, with greater improvement in the combination group (p < 0.05). Clinical photographs demonstrated decreased pigmentation and inflammation, with 73.3% of patients reporting satisfaction. VISIA analysis confirmed the significant decrease in the score of speckle, brown speckle, red region and UV speckle, further confirming the positive impact of the combination therapy on melasma. No severe adverse events occurred. CONCLUSION: The combination therapy of IPL and microneedling with a postbiotic formulation exhibits a multidimensional synergistic effect, presenting a promising new direction for melasma therapy.