Microneedling combined with topical plant-derived exosome therapy for refractory melasma in Fitzpatrick skin type V

A 62-year-old Hispanic woman with longstanding facial melasma that had failed both hydroquinone and topical tranexamic acid. Four Collagen P.I.N. sessions at two-week intervals, each followed immediately by a plant-derived exosome serum.

Melasma is common in darker phototypes, and it is precisely there that procedural therapy is hardest to justify: the risk of postinflammatory hyperpigmentation has to be weighed against the benefit. Microneedling is generally favored in skin of color because it avoids bulk thermal injury, but published evidence pairing it with topical exosomes has so far enrolled only Fitzpatrick I–III patients.

This report documents the combination in Fitzpatrick type V skin, using a plant-derived rather than stem-cell-derived formulation — two differences the authors consider clinically meaningful. Serial photographs after each session show progressive lightening of facial hyperpigmentation, with the estimated mMASI falling from approximately 8 to 4.

The authors are explicit about what a single case cannot establish. This is one patient with short follow-up. Photography was not standardized between sessions, and no true pre-treatment baseline photograph was available — improvement is measured against the first post-treatment image. The relative contributions of needling, exosome application, and daily sunscreen cannot be separated. Particle characterization of the serum is manufacturer-reported and was not independently verified.

What it does support is a controlled prospective study in skin of color, with standardized baseline photography, mMASI scoring, and longer follow-up.