Maribel C Sanchez Meza
Melasma is a chronic acquired hyperpigmentation disorder that commonly affects sun-exposed areas of the face and may significantly impact quality of life. Treatment can be challenging because of frequent recurrence and variable responses to conventional therapies. This case report describes the management of refractory facial melasma in a 64-year-old patient with a history of prolonged ultraviolet exposure and persistent facial hyperpigmentation. The patient previously underwent multiple treatment modalities, including chemical peels, mechanical peels, and laser-based therapies, without achieving satisfactory clinical improvement. Due to the limited response to these conventional approaches, treatment with the NewMelan Depigmentation System, a topical depigmenting formulation containing arbutin 1.5%, kojic acid 1%, and azelaic acid 1.5%, was initiated. The treatment protocol consisted of topical application three times daily during the first week, twice daily during the second week, and once daily during the subsequent two weeks, followed by maintenance therapy and continued photoprotection. Progressive reduction in facial hyperpigmentation was observed throughout the treatment period. After one month of therapy, the pigmentation became markedly less noticeable, resulting in substantial cosmetic improvement and high patient satisfaction. Continued maintenance treatment and daily sun protection contributed to preservation of the clinical outcome. This case highlights the potential role of the NewMelan Depigmentation System as a therapeutic option for patients with refractory facial melasma who have not responded adequately to conventional treatment modalities. Further clinical studies are warranted to evaluate long-term outcomes, safety, and efficacy in larger patient populations.