Melasma - Symptoms and Treatment

Melasma is a dark skin discoloration found on sun-exposed areas of the face. Although it can affect anyone, melasma is particularly common in women, especially pregnant women and those who are taking oral contraceptives or hormone replacement therapy (HRT) medications. Melasma appears as a blotchy, brownish pigmentation on the face that develops slowly and fades with time. Chloasma usually affects women but occasionally is seen in young men who use after-shave lotions, scented soaps, and other toiletries. The disorder is most common in sunny climates and in people of Latin or Asian origin. Melasma is more apparent during and after periods of sun exposure and less obvoius in winter months, when sun exposure is lacking.
Melasmapresents itself in one of the three usually symetrical facial patterns. The most common is a centrofacial pattern involving the cheeks, forehead, upper lip, nose, and chin. Less common are the malar pattern, involving the cheeks and nose, and the mandibular pattern, involvong the ramus of the mandible (the side of the cheeks and jawline). Melasma also occurs on the forearms, but this is rare.

Melasma is a peculiar disorder of the skin. Different types of melasma occur depending on the location of the excess melanin, in the epidermis or the dermis. Melasma is thought to be caused by elevated levels of estrogen, progesterone, and melanocyte-stimulating hormone (a hormone that causes melanin cells to make more melanin). Although this condition is typically termed the 'pregnancy mask', men can also develop this condition. If you have melasma, use a sunscreen at all times because sunlight worsens your condition.

Causes of Melasma

Common Causes of Melasma :

• Some anti-malarial drugs and antibiotics can trigger melasma.
• Waxing of facial hair especially above lips.
• The main cause of melasma is uncertain. People with a family history of melasma are more likely to develop melasma themselves. A change in hormonal status may trigger melasma.
• Sun exposure does appear to be a stimulating factor in predisposed individuals.
• Women who are taking oral contraceptives are at risk of developing melasma.

Symptoms of Melasma

Some common Symptoms of Melasma :

• Tan, dark brown patches.
• Irregular in shape.

Treatment of Melasma

• Hydroquinone creams, can help fade existing melasma spots. Doctors usually recommend prescription hydroquinone products when less-concentrated over-the-counter formulations aren't effective.
• Chemical peels, are liquid solutions applied to the skin to provide a mild chemical burn, similar to sunburn. Over time, the burned layers peel off, leaving fresh, new skin. Chemical peels vary in strength.
• Shade Lotion SPF 45
• Laser treatment
• The most common treatment is a prescription bleaching cream used with or without the antiwrinkle cream Renova and the anti acne cream Azelex . If the areas of melasma are small, they can be treated with the pigment gel kogic acid (purchased at a dermatologist's office) or with a direct freezing spray.

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