Melasma is a common skin pigment disorder of women between the ages of 20 and 50. Causes of melasma include sun, ultraviolet exposure, pregnancy, oral contraceptives, and certain drugs.
Clinically, melasma is characterized by irregularly shaped hyperpigmented areas of a beige or brown color. These areas usually occur on areas of the face exposed to sun, for example, the upper lip, cheeks, and forehead.
Therapy for melasma consist of topical application of hypopigmenting agents. These agents include hydroquinone, retinoic acid and azelaic acid. Laser resurfacing has been used in the past, but side effects include persistent erythema, hypo / hyper pigmentation, and hypertrophic scarring. Dermal needling (or fractional dermabrasion) when used with topical depigmenting serum has been shown to significantly improve appearance and spectroscopic indices (Fabbrocini et al., 2011).