Background: Melasma is a common skin condition characterized by hyperpigmented patches, predominantly affecting women and often exacerbated by hormonal fluctuations and sun exposure. This case study evaluates the effectiveness of a homeopathic treatment approach for a patient with chronic melasma. Case presentation: A 38-year-old female presented with persistent melasma for 8 years, worsened by sun exposure. She was very much conscious about her looks and depressed. She reported no significant medical history or family predisposition to skin disorders. The patient was taken according to homoeopathic principles. She was prescribed Sepia 200 one dose weekly after considering Homoeopathic repertory and individualisation. Berberis aquifolium mother tincture as an external application was also given. Disappearance of pigmentation and improved skin texture were observed along with enhanced patient satisfaction and self-esteem. There were no adverse effects reported throughout the treatment. Conclusion: This case demonstrates that a holistic treatment approach incorporating homoeopathic remedies can lead to significant improvements in chronic melasma. Continued follow-up and a personalized skincare regimen are also essential for maintaining results and preventing recurrence.