Utilizing fractional resurfacing in the treatment of therapy‐resistant melasma

Abstract

BACKGROUND: Multiple treatment modalities have been employed for the management of melasma with minimal to no success. OBJECTIVE: We propose fractional resurfacing as a new treatment modality for melasma. METHODS: A 31-year-old Caucasian female with facial epidermal and dermal melasma, resistant to multiple courses of topical therapies, was treated with two sessions of full-face fractional resurfacing (Fraxel(TM) Laser; Reliant technologies, San Diego, CA), separated by a three-week interval. Clinical improvement was assessed by Wood's Lamp examination as well as parallel and cross-polarized comparative photography at baseline and 6 months later. RESULTS: Marked reduction in epidermal and dermal facial pigmentation was observed at the six-month follow-up visit. CONCLUSION: Fractional resurfacing may prove to be an effective and safe treatment modality for lightening of the epidermal and dermal pigmentation of melasma. Further studies with long-term follow-up periods and multiple patients with diverse skin phototypes and different variants of melasma are warranted.