Last reviewed by Dr.Mary on August 7th, 2018.

What is Melasma?

This is a skin discoloration which is normally patchy brown, tan or blue-gray on facial skin. It is almost totally seen in women during reproductive years. Melasma normally appears in those women 20 to 50 years of age. It is fairly uncommon in males but it is possible.

It is believed to be mainly related to external sun exposure, external hormones such as birth control pills as well as internal hormonal changes as are usually seen in pregnancy. The majority of individuals with melasma have a background of daily or intermittent exposure to the sun. Melasma is more frequently found among women who are pregnant – especially those of Asian as well as Latin descents. Those with darker or olive skin, such as Middle Eastern, Hispanic as well as Asian – have a much higher rate of melasma.

It is estimated that 6 million women in the United States have melasma and 45-50 million women globally have melasma. Primarily prevention is aimed at sun protection for the face as well as sun avoidance.

Clinical studies show that individuals normally develop melasma during the summer months, as that is when the sun is most intense. In winter, the hyperpigmentation in melasma is less visible or lighter.

When this condition occurs during pregnancy, it is known as chloasma or “the mask of pregnancy”.

Melasma Symptoms

Melasma may develop on the upper lip, forehead, nose as well as cheeks in brownish colors. It normally appears in dark or irregular patches. There are no further symptoms associated with this condition. Melasma produces tan-brown, large, patches which are irregular, allocated symmetrically on the sides of the nose, cheeks as well as the forehead.

The symptoms of melasma are:

  • Irregular in shape
  • Dark brown or tan patches
  • Appears as dark or irregular patches
  • Distributed on cheeks, sides of the nose, forehead

Melasma Causes

  • Mostly associated with female hormones progesterone and estrogen. Common in pregnant women, women who are on the pill, and women taking hormone replacement therapy.
  • Sun exposure is strong risk factor.
  • Develops due to a combination of genetic, hormonal as well as sun related factors.
  • Both UVA and UVB contribute to the formation of melasma in those who are predisposed.
  • Can develop in association with menopause, ovarian disorders as well as hormonal imbalance.
  • Triggered by medication known as Dilantin.
  • Seen in young men who use lotions, scented soaps, after-shave as well as other toiletries.
  • Side-effect of contraceptive pills as well as injected depot contraceptive preparations.
  • Sun exposure
  • Use of deodorant soaps, toiletries which are scented, various cosmetics.
  • Deficiency of folic acid during pregnancy.

Melasma Treatment

Treatments for melasma can include:

  • Bleaching cream which contains hydroquinone as well as tretinoin cream which fades melasma but this should be avoided during pregnancy.
  • Laser treatment can help to remove skin discoloration.
  • Avoid sun exposure for long periods.
  • Use sunscreen creams and lotions daily.
  • Use only cleanser or mild soaps for washing face.
  • Apply bleaching creams on the area which is affected for 6-8 months.
  • Use fruit cream containing fruit acid, lactic acid, or glycolic acid.
  • Cosmetics which camouflages is also beneficial.
  • Protect skin from sun with sunscreen with SPF 8 or above.
  • Stopped the use of creams, make-up, facial cleansers or lotions which may irritate your skin.
  • Chemical peels, microdermabrasion, or laser surgery can also help to treat melasma. Use facial peels with alpha hydroxyacids or chemical peels with glycolic acid.
  • Use Retin-A cream before bedtime to affected area – this is effective and a safe process.
  • Take supplements of anti-oxidant such as Pycnogenol tablets 25 mg with meals 3 times daily can enhance results of any melasma treatment.
  • Use potent, lightening cream which are natural and contain antioxidants for the skin.
  • Use calamine as moisturizing lotions as well as extracts which are soothing to maintain skin after successfully curing melasma.

Melasma is a condition that is benign and does not usually require treatment but if it becomes bothersome, the individual should see their primary care physician.

Melasma Pictures

Melasma Before and After Photo

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