Melasma/Pigmentation

pigmantation

What is melasma?

  • Melasma is an acquired pigmentary condition of sun-exposed skin, often manifesting as dark patches.
  • Another term is chloasma which is often used to described melasma develop during pregnancy.

How does one get melasma? What are the predisposing factors for melasma?

  • What causes melasma is not yet clear. It is likely to occur when the colour making cells in the skin (melanocytes) of the affected areas produce too much colour.
  • Common contributory factors include sun exposure, pregnancy, drugs such as phenytoin, oral contraceptive pills or hormone replacement therapy, family history, hypothyroidism and thyroid autoimmunity.

Is melasma hereditary?

No melasma is not hereditary, however it is common in other family members.

How does melasma appear?

  • Melasma appear more commonly in women than men.
  • It appears as brown, grey or black patches affecting the sun exposed areas.
  • Cheeks, forehead, upper lip, nose and chin are involved usually in a symmetrical manner.
  • Often, it may be limited to the cheeks and nose area. Other sun-exposed area such as neck and the forearm are uncommonly affected.
  • The skin lesion are not itchy, but poses a significant cosmetic problem.

FAQ on Pigmentating Treatment

  • All dark patches on the face are not melasma.
  • Consult a dermatologist who will confirm the diagnosis and start appropriate treatment.
  • Self-medication with steroid containing creams should be strictly avoided.
  • Melasma is usually diagnosed by the clinical appearance of skin lesions.
  • A dermatologist can confirm the diagnosis by simple examination with a dermatoscope.
  • Occasionally skin biopsy may be needed to differentiate melasma from other pigmentary condition.
  • Melasma responds poorly to treatment. Generally sun protection measures along with a combination of various treatment modalities is helpful.
  • Use broad spectrum sunscreen.
  • Discontinue hormonal contraception.
  • Skin lightening cream prescribed by dermatologist.
  • Oral medication like tranexamic acid and glutathione.
  • Chemical peels
  • Laser therapy
  • Melasma can not be fully cured, however multiple treatment options available n improve the appearance.
  • Melasma tends to recur and recurrence rates are higher if sun protective measures are not adequately followed.
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