Management of Refractory Facial Melasma Using the NewMelan Topical Protocol Following Multiple Unsuccessful Treatment Modalities: A Case Report

Melasma is a chronic and recurrent facial hyperpigmentation disorder that can be challenging to manage, particularly in individuals with frequent sun exposure and a history of unsuccessful treatment.This case describes a 37-year-old medically healthy woman with persistent facial melasma and substantial occupational sun exposure related to her work in a beach environment.The condition had become a significant esthetic concern and negatively affected her self-confidence.The patient reported multiple previous treatment attempts, including chemical peels, laser-based procedures, and topical depigmenting therapy with hydroquinone, tretinoin, and niacinamide, without satisfactory improvement.Following clinical evaluation and the exclusion of a known hormonal or relevant systemic disorder based on the patient's medical history, an individualized topical protocol using NewMelan PRO (Krulig International Inc., Pembroke Pines, Florida, United States) and NewMelan Day & Night (Krulig International Inc., Pembroke Pines, Florida, United States) was initiated without concurrent laser therapy, chemical peeling, microneedling, injectable treatment, or additional depigmenting agents.NewMelan PRO was initially applied as a thin, full-face mask, followed by a structured regimen of NewMelan Day & Night with progressively adjusted application frequency and subsequent maintenance therapy.Progressive improvement in facial hyperpigmentation was observed during treatment.At approximately 10 days, qualitative clinical examination and comparison with the baseline photographs indicated a visible reduction in the intensity and extent of pigmentation, with further visible improvement documented at the 15 day clinical assessment.The patient continued topical NewMelan (Krulig International Inc., Pembroke Pines, Florida, United States) therapy thereafter as part of the treatment and maintenance regimen.No validated standardized scoring system, colorimetry, or spectrophotometry was used.The patient reported high satisfaction with the clinical outcome.This case documents short-term clinical improvement in persistent facial melasma during a structured NewMelan topical protocol following several previously unsuccessful treatment modalities.However, as a single patient observation involving nonstandardized clinical photography and short-term assessment, the findings do not establish causality, comparative efficacy, or long-term treatment durability.This case highlights the importance of individualized management, careful assessment of previous therapies, continued maintenance treatment, and photoprotection in patients with persistent melasma.