A Retrospective Analysis of Radiofrequency Microneedling for Melasma Management in the Japanese Population

Background: Melasma is a chronic pigmentary disorder with multifactorial pathogenesis and significant psychosocial impact. Although radiofrequency microneedling has emerged as a dermal-targeting adjunctive therapy, real-world evidence regarding its clinical effects and safety is limited. Objective: To evaluate the real-world clinical response and safety of POTENZA TM radiofrequency microneedling for melasma treatment. Methods: A retrospective observational before-and-after study was conducted at a private dermatology center in Japan. Adult patients with clinically diagnosed melasma who underwent POTENZA TM radiofrequency microneedling treatment were included in the analysis. Melasma severity was assessed using the modified Melasma Area and Severity Index (mMASI) score. Patient-reported satisfaction, qualitative clinical improvement, and adverse events were analyzed descriptively. Results: A total of 29 female patients (mean age, 45.2 ± 7.9 years) were included in the study. The median baseline mMASI score was 6 (IQR 4– 12) and remained 6 (IQR 4– 8) after treatment, with no statistically significant difference between the time points (p = 0.16). Overall, 26 patients (89.7%) demonstrated stable or improved mMASI scores post procedure. Percentage-based analyses showed substantial interindividual variability: 27.6% of patients achieved≥ 25% and ≥ 30% reductions in mMASI, and 10.3% achieved≥ 50% reduction. Patient satisfaction was reported in 62.1% of the cases. All patients experienced mild, transient erythema that resolved without sequelae, and no serious adverse events were observed. Conclusion: In this real-world study involving Japanese patients, POTENZA TM radiofrequency microneedling demonstrated a favorable safety profile and provided clinically meaningful improvements in selected patients, supporting its role as a complementary treatment in multimodal melasma management. Keywords: melasma, MASI, hyperpigmentation, radiofrequency microneedling, POTENZA, mMASI