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Melasma (also called as chloasma or the mask of pregnancy when present in pregnant women ) is a dark skin stain found on sun-exposed areas of the face. It offers as symmetric hyperpigmented macules, which can be merging or punctate. Though it can affect anyone, melasma is specifically common in women, especially pregnant women and those who are taking oral contraceptives or hormone replacement therapy medications. It is specially common in women aged 20-40. It targets the forehead, cheeks and upper lips. It occurs basically during pregnancy and is more common in dark skins than in fair skins. The disorder is most common in sunny climates and in people of Latin or Asian origin.

Melasma produces anomalistic, patchy areas of dark color that are the same on both sides of the face. The darker-colored patches of skin can be any shade, from tan to deep brown. Rarely, these dark patches may visible on other sun-exposed areas of the body. The proportion of melasma distinguishes it from other conditions that cause darkening of the skin.

Melasma is thought to be caused by hoisted levels of estrogen, progesterone, and melanocyte-stimulating hormone. Men can also develop this complication. The brown color often vanishes in winter and gets worse in the summer. Sun exposure is also a potent risk factor for melasma. It is specifically common in tropical climates. Persons of any race can be influenced. Though, it is much more common in connaturally darker skin types than in lighter skin types, and it may be more common in light brown skin types.

The prevalence of melasma also increases in patients with thyroid disease. It is believed that the overproduction of melanocyte-stimulating hormone brought on by stress can cause outbreaks of this condition. Melasma is frequently diagnosed visually or with assistance of a Wood lamp. Within a patch of melasma, pigment producing cells (called melanocytes) are increased in number and each melanocyte creates more pigment (called melanin). When a pregnancy ends or hormone treatment is relinquished, the patches usually disappear in a few months.

Causes of Melasma

The common causes and risk factor's of Melasma include the following:

  • Pregnancy (mask of pregnancy) is the most common cause of melasma.
  • Genetic predilection is also a major factor in determining whether someone will develop melasma.
  • Cellular hypersensitivity to normal estrogen levels.
  • Women who are taking oral contraceptives are at risk of developing melasma.
  • Sun exposure is also a strong risk factor for melasma.
  • The incidence of melasma also maximises in patients with thyroid disease.

Symptoms of Melasma

Some sign and symptoms associated to Melasma are as follows:

  • Dark patches commonly found on the upper cheek, nose, lips, upperlip, and forehead.
  • Irregular in shape.
  • Occassionally people have the patches only on the sides of the face. Rarely, melasma develops on the forearms.
  • A uniform brown color is usually seen over the cheeks, forehead, nose, or upper lip.
  • The patches do not itch or hurt and are only of cosmetic significance.
  • There is no other symptoms are found in case of severe Melasma.

Treatment of Melasma

Here is list of the methods for treating Melasma:

  • Topical depigmenting agents, such as hydroquinone (HQ) either in over-the-counter (2%) or prescription (4%) strength. HQ is a chemical that inhibits tyrosinase, an enzyme involved in the production of melanin.
  • Use sunblock lotions or creams with SPF-30.
  • Tretinoin is a type of vitamin A that helps to increase the rate at which dead skin cells fall off and new ones appear. This makes the melasma patch fade more quickly as the pigmented cells are shed.
  • In serious cases, laser treatments can be used to remove the dark pigment.
  • Camouflage cosmetics are also very valuable to treat melasma.
  • In many cases, chemical peels, or Microdermabrasion are also used for removing melasma.