Melasmahttps://en.wikipedia.org/wiki/Melasma
Melasma is a tan or dark discoloration of the facial skin. It is thought to be caused by sun exposure, genetic predisposition, hormonal changes, and skin irritation. Although anyone can develop melasma, it is especially common in women, particularly those who are pregnant or who are using contraceptives or hormone‑replacement therapy.

Melasma cannot be permanently resolved with laser treatment because pigment production is ongoing. Tranexamic acid helps to reduce the pigmentation.

○ Treatment
In some countries (e.g., Japan, Korea), oral tranexamic acid is available over the counter and is effective. A melasma cream containing tranexamic acid and azelaic acid may provide partial benefit.
Hydroquinone can be used topically for hyperpigmentation, but the FDA halted the sale of over‑the‑counter products containing hydroquinone in 2020.
#Tranexamic acid [TRANSINO]

#Laser toning technique (low fluence QS1064 laser)
#Triluma
☆ In the 2022 Stiftung Warentest results from Germany, consumer satisfaction with ModelDerm was only slightly lower than with paid telemedicine consultations.
  • It is a common condition observed in Asian women in their early 40s. The circled lesion in the photo is closer to lentigo rather than melasma.
    References Efficacy and Safety of Tranexamic Acid in Melasma: A Meta-analysis and Systematic Review 28374042
    Tranexamic acid is a new option for treating melasma. When only tranexamic acid was used, there was an average decrease of 1.60 in the Melasma Area and Severity Index (MASI) after treatment. Adding tranexamic acid to regular treatments resulted in a further decrease of 0.94 in MASI. These findings support that tranexamic acid is effective and safe, either on its own or alongside regular treatments for melasma.
     The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma: A Systematic Review 35888655 
    NIH
    Recently, the low-fluence Q-switched Nd:YAG laser (LFQSNY) has been widely used for treating melasma, especially in Asia. It was hard to summarize the heterogenous studies, but LFQSNY appeared to be a generally effective and safe treatment for melasma considering the results of previous conventional therapies. However, mottled hypopigmentation has been occasionally reported to develop and persist as an adverse event of LFQSNY, which may be associated with the high accumulated laser energy. When used aggressively, even LFQSNY can induce hyperpigmentation via unwanted inflammation, especially in darker skin.
     Pigmentation Disorders: Diagnosis and Management 29431372
    Pigmentation problems are often found in primary care. Common types of hyperpigmentation disorders include post-inflammatory hyperpigmentation, melasma, sunspots, freckles, café au lait spots.