Melasma

Alternative Names

Chloasma; Mask of pregnancy; Pregnancy mask

What is Melasma

Melasma is a common skin disorder characterized by dark facial skin with irregular borders. It is usually found on the cheeks, lips, forehead or nose and is seen in all skin types. It is very common, especially in women of child-bearing age. However, up to 10% of cases have been reported in males. While all races are affected, there is a prominence among Latinos and Asians. Melasma is more apparent during and after periods of sun exposure and less obvious in winter months, when sun exposure is lacking.

Melasma also occurs on the forearms, but this is rare.

Signs and symptoms

Melasma doesn't cause any other symptoms except skin discoloration but it may be of great cosmetic concern.

A uniform brown color is usually seen over the cheeks, forehead, nose, or upper lip. It is most often symmetrical matching on both sides of the face.

Possible complications

There are no exact complications for now. In most cases Melasma will remain with you until after you have given birth. However, in some cases it does not fade immediately and it can take anywhere between 3-6 months for the full effects to vanish. It must also be said that there have been some women who have had the symptoms for much longer, although they do eventually vanish completely.

What causes

The exact cause of melasma is also unknown. Doctors believe that the dark patches in melasma could be triggered by several factors, including pregnancy, birth control pills, hormone replacement therapy (HRT and progesterone), family history of melasma, race, antiseizure medications, and other medications that make the skin more prone to pigmentation after exposure to ultraviolet (UV) light. Uncontrolled sunlight exposure is considered the leading cause of melasma, especially in individuals with a genetic predisposition to this condition. Clinical studies have shown that individuals typically develop melasma in the summer months, when the sun is most intense. In the winter, the hyperpigmentation in melasma tends to be less visible or lighter.

Prevention

There is a good chance to develop melisma if your estrogen rises, due to pregnancy or taking the pill. The main way to prevent it is by staying out of the sun (and tanning booths) completely. The second way is to wear a good sunscreen at all times – even if you leave the house for only 5 minutes to run an errand. Zinc Oxide based sunscreens are the absolute best for protecting your skin from the sun, and I write in depth about Zinc Oxide sunscreens here. I would recommend a sunscreen with at least 10% Zinc Oxide, and at least SPF 30 at all times! Make sure to reapply if you are outdoors for more than a few hours, and reapply after swimming or sweating. Unfortunately, Melasma can happen quickly, and just one day of sun exposure without a good sunscreen can cause it. Once you get Melasma, it’s difficult to get rid of, at least quickly, so protection is by far your most important measure.

Treatment

Treatments of Melasma include:

• Creams containing a combination of tretinoin, kojic acid, and azelaic acid have been shown to improve the appearance of melasma.
• Consult with your doctor and he may recommend chemical peels or topical steroid creams.
• Laser treatments can be used to remove the dark pigment if you have severe case.
• Avoiding the sun and using sunscreen are key to preventing melasma.