Background/Objective: Melasma is a common disorder of hypermelanosis, and although numerous treatment modalities have been employed, many cases are refractory to treatment or the improvement after therapy is temporary. Methods: The clinical files, treatment parameters, and photographs of a 59-year-old female with black skin with refractory malar dermal melasma treated using a fractionally ablative CO2laser (Affirm 10 600 nm) for seven sessions were carefully reviewed. Results: After treatment, clinical improvement was achieved. Conclusion: The fractional ablative CO2laser is a potentially safe and effective modality for the treatment of dermal melasma in Fitzpatrick type V skin. © 2010 Informa UK, Ltd.