Microneedles for the treatment of migraine and orofacial pain: A narrative review.

Researchers reviewed studies examining microneedles—tiny needle devices that deliver medication through the skin—as a treatment for migraine and orofacial pain conditions. Unlike traditional acupuncture needles used for energy flow, microneedles are a modern drug-delivery technology designed to release medication directly into affected areas. The review included 11 studies covering migraine, temporomandibular joint disorders (TMJ/TMD), and mouth ulcers. For migraine specifically, researchers found that microneedles delivering triptan medications (common migraine drugs) provided fast pain relief within 2 hours and helped eliminate bothersome migraine symptoms like nausea and light sensitivity. The medication absorbed as effectively as injections but with only mild, temporary skin reactions at the application site. This technology bypasses the stomach, which is important since migraine often causes delayed stomach emptying that interferes with oral medication absorption. For TMJ disorders and mouth ulcers, early research showed microneedles could deliver pain relief and anti-inflammatory effects directly to painful areas and promote healing, though evidence remains preliminary. While this technology shows promise for faster and more reliable migraine relief compared to pills, it's important to note that microneedles are a pharmaceutical device, not acupuncture therapy. Patients interested in traditional acupuncture for migraine management should consult a licensed acupuncturist (L.Ac.) who can provide individualized treatment based on traditional Chinese medicine principles.

This narrative review synthesized 11 studies evaluating microneedle (MN) technology for migraine (n=4), temporomandibular disorders (n=2), and oral mucosal ulcers (n=5). The review searched PubMed/MEDLINE, Embase, Web of Science, and Google Scholar through November 2025, including preclinical and clinical studies. For migraine, transdermal and intranasal MN systems demonstrated bioavailability comparable to subcutaneous injection. Clinical trials of MN-delivered triptans reported high rates of 2-hour pain relief and freedom from most bothersome symptoms, with mild, transient local reactions. MNs circumvent gastrointestinal absorption limitations relevant in migraine-related gastroparesis. For TMD and oral ulcers, preclinical evidence showed localized analgesic, anti-inflammatory effects and enhanced tissue healing, though clinical translation remains limited. Clinical takeaway: While MN technology represents pharmaceutical drug delivery rather than acupuncture, practitioners should recognize this emerging modality as a potential complement to traditional approaches for migraine management, particularly for patients requiring rapid, reliable acute treatment with enhanced bioavailability.