Treatment of Hyperpigmentation After Sclerotherapy Through Mesotherapy With Deferoxamine Mesylate: A Case Series

Post-sclerotherapy hyperpigmentation is a relatively frequent complication, often associated with considerable aesthetic concern and potential long-term persistence. The underlying pathophysiology mainly involves dermal hemosiderin deposition, inflammatory responses, and secondary melanogenesis induced by the local inflammatory environment. Deferoxamine mesylate, a well-established iron-chelating agent, has attracted attention as a potential therapeutic modality for hyperpigmentation, aiming to improve clinical outcomes. This case series presents the therapeutic experience of intradermal administration (mesotherapy) of deferoxamine mesylate in patients with persistent post-sclerotherapy hyperpigmentation. This case series describes three female patients aged 35, 58, and 45 years, respectively, who presented with persistent hyperpigmentation lasting more than three months after sclerotherapy. All patients underwent monthly intradermal mesotherapy using deferoxamine mesylate. Treatment response, safety, and patient satisfaction were assessed. Two patients achieved satisfactory pigmentation lightening after three sessions, while only one patient required four sessions to achieve adequate lightening of the affected skin. All participants reported high levels of satisfaction with the aesthetic result. No significant adverse effects were documented, except for mild (erythema) and transient local reactions at the injection sites. Mesotherapy with deferoxamine mesylate demonstrated a favorable safety profile and promising efficacy in the treatment of persistent hyperpigmentation after sclerotherapy. These findings corroborate its potential for incorporation as an adjuvant therapeutic option in the clinical arsenal for pigmentation disorders following vascular procedures.