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Utilizing fractional resurfacing in the treatment of therapy‐resistant melasma

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 (FraxelTM 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