Melasma is a condition where one develops dark brown and gray patches most notably on the forehead, upper lip, nose and cheeks. It can also occur on the forearms and neck.
When melasma occurs during pregnancy, it is also called chloasma, or “the mask of pregnancy
Melasma occurs much more often in women than in men.
Melasma often affects women who:
- are pregnant
- have family history
- take oral contraceptives or hormone therapy
- females with darker skin-tones
- who live in sunny places.
Presentation:
- Gradual in onset
- The pigmentation mainly occurs on the face and is usually bilateral
- The colour may vary from tan to brown but may be black or have a bluish tinge
- The distribution is usually symmetrical and three patterns are commonly seen – centrofacial, malar(cheek bone) or mandibular(jaw line)
Prevention:
- Use a good sunblock before stepping out in the sun. Use SPF 30 ideally, as it battles the harmful UVA and UVB rays.
- Make sure you apply sunblock even while you are indoors. UV rays usually creep in.
- Use facial cleansers and creams that are gentle in composition and mild on your skin.
- Stay away from strong chemical formulations that tend to only aggravate the problem.
- Use bathing shower gels that are milder with natural extracts and less of chemicals.
- Do not use soaps and gels with strong perfumes.
- Do not use skin bleaching agents in a desperate attempt to look fair. This will only make your skin look worse.
- Make sure you wear a light concealer if you have to attend a gathering.
- If exposure to sunlight cannot be avoided, then hats, scarf can be worn.
Treatment:
Although Melasma is self-limiting(Fades on its own),also it is notoriously difficult to treat. Dermatologist may look into the following options.
- Topical Skin-lightening agents, particularly hydroquinone 2-4%
- Retinols
- Ascorbic acid (vitamin C). This works through inhibiting pigment production
- Chemical peels that contains glycolic acid
- Pixel laser can also be helpful
See doctor if:
Pigmentation that causes pain, redness and bleeding.
Changes noticed in the shape of skin structures, such as moles.
It is important not to stress yourself looking at the pigmented skin. Your mental anxiety can flare up the condition. Discuss the options for treatment of melasma with your dermatologist.
If you are breastfeeding and lactating, share this information with your doctor right away, as medications can be expressed into breast milk while nursing.
-Dr. krishnapriya
References:
https://emedicine.medscape.com/article/1068640-overview#a3
https://www.health.harvard.edu/skin-and-hair/melasma-chloasma-
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