Melasma

Melasma

Melasma is a skin condition presenting as brown patches on the face of adults. The most common sites of involvement are the cheeks, bridge of nose, forehead, and upper lip.

Who Gets Melasma?

Melasma

Melasma mostly occurs in women. Only 10% of those affected are men. Dark-skinned races, particularly Hispanics, Asians, Indians, people from the Middle East, and Northern Africa, tend to develop melasma more than others.

What Causes Melasma?

Melasma

The precise cause of melasma is unknown. People with a family history of melasma are more likely to develop melasma themselves. A change in hormonal status may trigger melasma.

It is commonly associated with pregnancy and called chloasma, or the “mask of pregnancy.” Birth control pills (due to estrogen) appear to increase the risk of melasma, however, hormone replacement therapy used after menopause has not been shown to cause the condition.

Melasma

Sun exposure certainly contributes to melasma. Ultraviolet light from the sun can stimulate pigment-producing cells, or melanocytes in the skin. People with skin of color have more active melanocytes than those with light skin. These melanocytes produce a large amount of pigment under normal conditions, but this production increases even further when stimulated by light exposure or an increase in hormone levels. Incidental exposure to the sun is mainly the reason for recurrences of melasma.

Melasma

Any irritation of the skin may cause an increase in pigmentation in dark-skinned individuals, which may also worsen melasma. Melasma is not associated with any internal diseases or organ malfunction.

How is Melasma Treated?

Melasma

While there is no cure for melasma, many treatments have been developed. While melasma may disappear after pregnancy or discontinuing an oral contraceptive, it may remain for many years, or a lifetime.

Sunscreens are essential in the treatment of melasma. They should be broad spectrum, protecting against both UVA and UVB rays from the sun. An SPF 30 or preferably higher should be selected, with medical grade quality being preferred. In addition, physical sunblock lotions and creams such as zinc oxide and titanium oxide, may be used to block ultraviolet radiation and visible light. Sunscreens should be worn daily, whether or not it is sunny outside and should be reapplied every 2-3 hours when out and about. A significant amount of ultraviolet rays is received while walking down the street, driving in cars, and sitting next to windows.

Melasma

Any facial cleansers, creams, or make-up that irritates the skin should be stopped, as this may worsen the melasma. If melasma develops after starting birth control pills, it may improve after discontinuing them or changing them to a lower estrogen dose. Melasma can be treated with bleaching creams while continuing birth control pills.

Melasma