Microneedling plus tacrolimus versus tacrolimus alone in conjunction with narrow band UVB in the treatment of vitiligo; A randomised control trial.


  • Tassmia Afzal Madinah Teaching Hospital, Faisalabad.
  • Tanzeela Khalid Madinah Teaching Hospital, Faisalabad.
  • Filzah Inam Madinah Teaching Hospital, Faisalabad.
  • Beenish Bajwa Ghurki Trust and Teaching Hospital, Lahore.
  • Saman Iqbal Goraya Sheikh Zayed Hospital, Lahore.
  • Shakeel Ahmad Faisalabad Medical University, Faisalabad.
  • Muhammad Ahsan Nusrat Fateh Ali Khan Hospital, Faisalabad.




Band UVB, Microneedling, Pigmentation, Tacrolimus, Vitiligo


Objective: To compare the efficacy of microneedling plus Tacrolimus with narrow band UVB versus tacrolimus with narrow band UVB in the treatment of vitiligo. Study Design: Randomized Controlled Trial. Setting: Department of Dermatology, Madinah Teaching Hospital, Faisalabad. Period: 05-06-2023 to 5-12-23. Methods: Enrolled 28 patients with stable Vitiligo for the last 3 months, aged 15 to 60 years. Patients were assigned to group A and B, treated with microneedling plus topical tacrolimus 0.1% with narrow band UVB and tacrolimus ointment twice a day. The study focused on evaluating the repigmentation response during subsequent follow-up visits, using a comprehensive four-grade scale. The results were analyzed using SPSS 26. Results: The study involved 34 patients with face lesions. Six patients lost follow-up and were excluded. The study included 16 males and 12 females, with a mean age of 29.4 + 11 years. After the treatment, the first follow-up visit showed significant improvement in 17 of 28 patients (60.7%) in group A (microneedling pus Tacrolimus with narrow band UVB) compared to 32.1% in group B (Tacrolimus with narrow band UVB). The efficacy was categorized into five levels: 'excellent' in 25% cases in group A and 21.4% in group B, and very good' in 35.7 vs 10.7%. At 12 weeks, overall efficacy was seen in 71.4% in group A and 39.3% in group B. The study's findings suggest that microneedling plus tacrolimus with narrow band UVB may be a more effective treatment for vitiligo. Conclusion: Microneedling, a technique using delicate needles to puncture the dermis, has been shown to promote collagen synthesis and enhance the absorption of tacrolimus, a drug used for immunosuppression, potentially aiding in vitiligo repigmentation, but further localized studies are needed.

Author Biographies

Tassmia Afzal, Madinah Teaching Hospital, Faisalabad.

FCPS, Resident Dermatology, 

Tanzeela Khalid, Madinah Teaching Hospital, Faisalabad.

MBBS, FCPS (Dermatology), PGR and Head Dermatology, 

Filzah Inam, Madinah Teaching Hospital, Faisalabad.

MCPS (Dermatology), Post graduate Resident Dermatology, 

Beenish Bajwa, Ghurki Trust and Teaching Hospital, Lahore.

FCPS (Dermatology), PGR, 

Saman Iqbal Goraya, Sheikh Zayed Hospital, Lahore.


Shakeel Ahmad, Faisalabad Medical University, Faisalabad.

MBBS, FCPS (Dermatology), Senior Registrar, 

Muhammad Ahsan, Nusrat Fateh Ali Khan Hospital, Faisalabad.

MBBS, PGPN, Deputy Medical Superintendent,