Diffuse Facial Melasma and Lentigines Treated With the NewMelan Multimodal Depigmentation Protocol: A Case Report

This case report describes a 75-year-old woman presenting with diffuse facial melasma, lentigines, and associated dyschromia. The NewMelan multimodal depigmentation protocol, developed by Dr. Eduardo Krulig, was utilized in the management of this patient, who was treated under his supervision. Clinical examination demonstrated bilateral facial hyperpigmentation with uneven skin tone and photoaging-related pigmentary changes consistent with mixed melasma and lentiginous pigmentation. A physician-supervised depigmentation regimen was initiated. During the first week, the depigmenting product was applied three times daily, followed by twice daily applications during the second week. After 15 days, the protocol continued with once daily application as part of the maintenance regimen. Marked clinical improvement in facial hyperpigmentation and skin tone uniformity was observed within approximately two weeks of treatment initiation. Serial clinical photography demonstrated substantial reduction in pigmentation intensity, near-complete resolution of the most prominent melasma lesions, and improvement in overall facial appearance. Post-treatment, the patient was instructed to continue daily maintenance therapy. This case demonstrates short-term clinical improvement following treatment with the NewMelan multimodal depigmentation protocol. Further studies with larger patient populations and longer follow-up periods are necessary to evaluate long-term outcomes, recurrence rates, and broader clinical applicability.