# Hyaluronic Acid, Succinic Acid, and Exosomes in the Treatment of Facial Hyperpigmentation: A Report of Two Cases

## TL;DR

This paper reports on two patients treated for facial hyperpigmentation using a combination of plant-derived exosomes, hyaluronic acid, and succinic acid, showing promising clinical outcomes.

## Contribution

The novel contribution is the combined use of plant-derived exosomes with hyaluronic and succinic acids for treating facial hyperpigmentation.

## Key findings

- The treatment protocol showed improvement in facial hyperpigmentation in both patients.
- The combined therapy was well-tolerated with no significant adverse effects reported.

## Abstract

Facial hyperpigmentation is a common clinical manifestation of various dermatologic conditions and may arise from multiple endogenous and exogenous factors. Its therapeutic management remains a clinical challenge due to its persistent nature and the limited long-term effectiveness of conventional treatment strategies. In recent years, emerging regenerative approaches, such as the use of exosomes and the combination of non-cross-linked hyaluronic acid with succinic acid, have been described in the international literature based on their biological, anti-inflammatory, and tissue microenvironment modulatory properties. In this case report, we present two patients with facial hyperpigmentation of similar etiology who were treated using a combined protocol based on plant-derived exosomes and non-cross-linked hyaluronic acid plus succinic acid. We describe the treatment protocol, follow-up, and the final clinical outcomes observed.