Seeking Help for Persistent Facial Melasma - #47197

I am a woman in my early 50s. I developed facial melasma in my early 40s, and it has steadily worsened over the past 10 years. I have consulted multiple dermatologists and undergone several treatments, including topical prescription creams, chemical treatments, laser procedures, and cosmetic face packs. None of these have led to lasting improvement. The pigmentation has continued to progress despite consistent treatment. Relevant medical history: I experienced early menopause around the age of 40. I had frequent gut-related discomfort for many years, described as an uneasy stomach without nausea or vomiting. This has improved in recent years. My blood tests have consistently shown a low white blood cell count over many years, while hemoglobin levels have remained normal. I have been diagnosed with osteoporosis. I have not been diagnosed with any autoimmune condition so far. I do not have significant sun exposure and follow recommended sun protection measures.