Background: Melasma is one of the most common causes of facial hyperpigmentation which causes cosmetic disfigurement and leads to psychological proplems, although various treatments are available for melasma, it remains a difficult condition to treat. Aim of Study : To evaluate and compare the efficacy of topical flutamide 1% alone and in-combination with Carboxytherapy in treatment of patients with melasma. Patients and Methods: The study included 30 female patients with different types and patterns of melasma. They were divided into two groups, each group included 15 patients: Group A, patients were treated with 1 % flutamide topical gel on the face and group B, patients were treated with 1 % flutamide topical gel on the face and carboxytherapy injection was done in both sides of the face every four weeks for three sessions. Results: Both groups showed highly significant decrease in mMASI score after the treatment in which group B showed better results with (p-value=0.048*) than group A with (p-value=0. 007*). Conclusion: As new treatment for melasma topical flutamide was effective and safe therapeutic modalities. Carboxytherapy could be effective and safe new treatment modality for melasma as adjuvant treatment with topical flutamide.