Melasma (Chloasma, Mask of Pregnancy)

What is melasma?

Melasma is a skin condition characterized by uneven, darkened patches of facial pigmentation. While it predominantly appears on the face, melasma can also develop on the arms, back, and other regions frequently exposed to the sun. Although anyone can experience melasma, it's notably prevalent in women, especially those who are pregnant. Although it poses no health risks, melasma can be a source of emotional distress and self-consciousness for many.

What causes melasma?

Melasma's pigmentation arises from melanin overproduction by melanocytes (pigment cells). A genetic component is also present, as many individuals with melasma have family members with similar conditions. For most affected individuals, melasma persists chronically, but it might improve with reduced sun exposure or post-pregnancy. Recognized risk factors encompass:

• Sun exposure and tanning (both UV and visible light)

• Pregnancy (pigmentation typically diminishes post-delivery)

• Hormonal treatments (birth control, hormone replacement therapy, IUDs)

• Conditions like hypothyroidism and Addison’s disease

• Specific medications (including certain cancer treatments) and some fragranced soaps, toiletries, and cosmetics

What are the symptoms of melasma?

Melasma presents as asymmetrical dark patches, spanning between 0.5 cm to 10 cm, predominantly on the face. These patches tend to intensify, particularly with consistent sun exposure. Besides the noticeable discoloration, melasma doesn't cause any physical discomfort or itching.

How do I treat melasma?

Initiating melasma treatment usually begins with identifying and eliminating its cause. For some, awaiting natural improvement after halting birth control or following pregnancy might suffice. Sunscreen application, wearing sun-protective attire, and sun avoidance prove beneficial. For many, however, medical treatments offer relief, such as:

• Skin-lightening creams (like hydroquinone)

• Topical retinoids (e.g., tretinoin)

• Topical azelaic acid

• Chemical peels

• Topical corticosteroids

• Laser therapies

• Oral or topical tranexamic acid

• Microdermabrasion or dermabrasion

How do I prevent melasma?

To lessen the likelihood of melasma onset, curtailing excessive sun exposure remains paramount. Regularly applying a tinted sunscreen infused with iron oxide boasting an SPF of at least 50 is advised. For many, avoiding birth control is impractical, but circumventing sun-induced skin damage is a feasible preventive measure.