This is a 25 year old female who had severe melasma that has been treated with multiple modalities. Over the years, the most consistent treatment for melasma is not physical treatments but the use of sunblock, hydroquinone, sun avoidance, and oral tranexamic acid if needed. The performance of procedures on patients with melasma does not guarantee improvement since melasma is an ongoing condition that cannot be cured. Melasma can be treated but since it is an ongoing condition, it requires patience, diligence, and time. This patient has had numerous procedures over the years that has helped improve her skin but despite procedures, her melasma recurs but as she continues her regimen, she always continues to look better. Melasma is frustrating but can be improved significantly over time.
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