الفهرس 
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Abstract
This study was carried out at the Dermatology, Venerology and Andrology Department at Assiut University Hospitals, Egypt, to evaluate and compare the efficacy and safety of topical silymarin alone versus its combination with microneedling in treatment of melasma. It was carried out on 30 patients. The age ranged from 27 and 62, most of them were females (97%).
Each side of the patients’ face was randomly allocated to either topical silymarin 0.7% and microneedling or topical silymarin 0.7% alone. All patients used topical SM 0.7% cream twice daily. One side of the face was subjected to three consecutive microneedling sessions, 4 weeks apart (0, 4, 8 weeks), which was performed by dermapen. The duration of treatment was 3 months. The clinical evaluation of the outcome was calculated with hemi-MASI and hemi -mMmasi.
Both combined topical silymarin 0.7% and microneedling therapy and topical silymarin 0.7% alone were effective in treatment of melasma. The difference between each of them in all studied parameters didn’t reach statistical significance.
Regarding safety, no complications were reported from the patients on the side treated with topical silymarin 0.7 % cream, while pain and transient erythema were occurred in all patients on the microneedling side.