Skinfinity Radio-frequency Ablation with Platelet-rich Plasma and Collagen Micropen has been shown to help melasma. It more importantly does not make it worse. It is done in a series of monthly treatments and helps improve texture and skin tone.
Tranexamic acid is the latest weapon in the fight against melasma. Initially developed to help disorders of increased bleeding, it was serendipitously found to help reduce melasma. In general, it is well-tolerated, and usually causes no side-effects. It should not be taken by people with any kind of bleeding disorder. It is used for a 12-week period to assess effect, in combination with fading creams and other treatments. It is, hoever, not a permanent solution, and treatment of some sort will be needed to maintain its effects.
Melasma is a challenge to successfully treat and requires great discipline with regards to continuous sun protection. Fortunately, most people can obtain satisfying results with a combination of sunscreen/avoidance and appropriate topical therapy.