Melasma is a common, acquired, esthetically disfiguring hypermelanosis of the face. Melasma is considered a disappointing challenge when treatment options are addressed. Diverse treatment modalities such as retinoic acid, hypo-pigmenting agents like hydroquinone, azelaic acid, and kojic acid, chemical peels, microdermabrasion, and lasers have been tried for the treatment of melasma. There is no universally proven therapy that induces and maintains remission of the condition. Q-switched: Nd YAG laser toning and platelet rich plasma (PRP) are promising treatments for melasma.The aim of this work is evaluate the efficacy and safety of combined PRP and Q-switched: NdYAG laser in the treatment of melasma using clinical assessment, in addition to assessment of Melanin Index and Erythema Index.

Inclusion Criteria:

• Patients with bilateral nearly symmetric melasma on the face.

Exclusion Criteria:

• Patients receiving systemic or topical or laser treatment relevant to melasma within three months before enrollment into the study.
• Use of oral or injectable contraceptives or hormone replacement therapy during treatment or 12 months before
• Patients active skin infections and active HSV
• History of hypertrophic scars or keloids.
• Patients with hypercoagulable state or bleeding diatheses
• Pregnant and lactating females.
• History of liver diseases
• Intake of systemic chemotherapy, corticosteroids, antiplatelets or anticoagulants