Hyaluronic Acid, Succinic Acid, and Exosomes in the Treatment of Facial Hyperpigmentation: A Report of Two Cases

Facial hyperpigmentation is a common clinical manifestation of various dermatologic conditions and may arise from multiple endogenous and exogenous factors. Its therapeutic management remains a clinical challenge due to its persistent nature and the limited long-term effectiveness of conventional treatment strategies. In recent years, emerging regenerative approaches, such as the use of exosomes and the combination of non-cross-linked hyaluronic acid with succinic acid, have been described in the international literature based on their biological, anti-inflammatory, and tissue microenvironment modulatory properties. In this case report, we present two patients with facial hyperpigmentation of similar etiology who were treated using a combined protocol based on plant-derived exosomes and non-cross-linked hyaluronic acid plus succinic acid. We describe the treatment protocol, follow-up, and the final clinical outcomes observed.