Fire Needle Combined With Excimer Laser Safe, Effective Therapy for Vitiligo, Review Finds

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When combined with a 308 nm excimer laser, the use of fire needles is both safe and effective in patients with vitiligo, according to the findings of a recent literature review published in the Journal of Cosmetic Dermatology.¹

According to the 2013 European Vitiligo Treatment Guidelines, experts recommend the use of combination therapy for patients with vitiligo in order to improve the recovery rate and reduce incidence of adverse events,² according to study authors Guo et al. Since 2013, researchers have evaluated the use of lasers, considered a first-line therapy for this indication, in combination with numerous other therapies.

Previously, researchers have explored the safety and efficacy of excimer lasers with calcineurin inhibitors, topical vitamin D3, analogues, corticosteroids, and topical tacrolimus, among others.³ In modern medicine, prior research has demonstrated the role of fire needle therapy in producing inflammatory factors, activating melanocytes in hair follicles, and promoting melanocyte migration, which may be indicative of potential in vitiligo, leading researchers to explore its use in combination with an already-established therapy.⁴

Researchers conducted a literature search across multiple databases, including PubMed, EMBASE, Cochrane Library, and others, to identify relevant randomized controlled trials. Papers eligible for inclusion in the review included randomized controlled trials reporting vitiligo diagnosis according to established criteria and evaluating the combination of fire needle therapy with 308 nm excimer laser therapy.

The study included 10 randomized controlled trials involving 946 patients, all conducted in China. Meta-analyses revealed significant improvements in the clinical effective rate, Vitiligo Area Score Index, Dermatology Life Quality Index, and serum T lymphocyte levels in patients receiving combined therapy compared with those undergoing laser therapy alone.

Adverse events, which were predominantly mild and transient in nature, were observed in both treatment groups, with no serious complications reported.

The study outlined several limitations. Due to the invasive nature of fire needle therapy, blinding and allocation concealment were not possible when comparing it with 308 nm excimer laser alone. Factors such as patient demographics, disease characteristics, and prior treatments were not adequately considered. The study had a relatively small sample size, limited to Chinese participants, potentially affecting generalizability.

"More high-quality experiments are needed to verify the effectiveness of fire needle combined with 308 nm excimer laser therapy for vitiligo treatment," according to Guo et al.

References

1. Guo C, Gu X, Zhang J, et al. Efficacy of fire needle combined with 308 nm excimer laser therapy for vitiligo: A systematic review and meta-analysis of randomized controlled trials. J Cosmet Dermatol. April 9, 2024. Accessed April 9, 2024. https://doi.org/10.1111/jocd.16308
2. Taieb A, Alomar A, Böhm M, et al. Guidelines for the management of vitiligo: the European Dermatology Forum consensus. Br J Dermatol. 2013. Accessed April 9, 2024. doi:10.1111/j.1365-2133.2012.11197.x
3. Post NF, Ezekwe N, Narayan VS, et al. The use of lasers in vitiligo, an overview. J Eur Acad Dermatol Venereol. 2022. Accessed April 9, 2024. doi:10.1111/jdv.18005
4. Sun LL, Liu HX, Wang ZZ, et al. Observation on therapeutic effect of filiform fire needle assisted 308 nm excimer laser on vitiligo of different parts. Chin Acupunct Moxibust. 2019. Accessed April 9, 2024.