What is Melasma?
Melasma, which is also commonly known as chloasma is a skin condition that is characterized by an increased pigmentation on face. This is seen most commonly on the face. The typical distribution of the hyperpigmentation on face helps to establish the diagnosis. The color of the patches could be a slight tan to dark brown. It is seen less commonly on other sun exposed areas of the body. It generally has a symmetrical distribution on the face.
Causes of Melasma
There are some identified causes and risk factors for melasma but the exact cause is still not known. It is seen more commonly in dark skinned individuals as compared to fair skinned persons. There is also a known link with the estrogen and progesterone levels in the body. Women are at a greater risk of developing this face pigmentation. Pregnancy and hormone changes occurring in the body as in HRT – Hormone Replacement Therapy or taking oral contraceptive pills are the major causes of melasma. Sun exposure is known to increase the pigmentation troubles. Overuse of cosmetics and some thyroid medications make your skin more sensitive to the rays of the sun. So, using a sun block becomes an important part of the treatment for melasma.
Symptoms of Melasma
Melasma causes patches of skin discoloration on forehead and face which can range from a tan to dark brown color depending on your skin type. These brown patches on face are symmetrically distributed and are seen more on the sun exposed areas of the body. It is common in pregnant women due to the hormonal changes and is also called as the mask of pregnancy. The typical distribution of the brown patches is over the forehead, bridge of the nose, both cheeks and the chin. The pregnancy mask causes the face looks like it has a butterfly shaped brown patch so it is also called as butterfly pigmentation.
It can also occur on the arms and neck region. These patches are harmless and have no serious implications except for cosmetic problems.
The pigmentation normally resolves or lightens on its own once the pregnancy is over or the hormone therapy is stopped within few months. In a very small percentage of women, the patches never completely fade away.
Diagnosis of Melasma
The diagnosis is mainly done by looking at the distribution of the skin patches and the presence of one or more of the risk factors like pregnancy, hormone therapy etc.
The confirmation of the diagnosis is done by Woods Lamp Examination. This testing is done by exposing the skin to a special type of light which helps to determine how many layers of skin are affected. If the doctor suspects another serious skin disorder, he may take a small biopsy from the patch and send it for testing. The cells identified under the microscope will help to establish the diagnosis more accurately.
Treatment of Melasma
Women who are on hormone replacement therapy see a regression in the dark patches once the medication stops. The patches resolve on their own in pregnant women once the pregnancy ends and the baby is born. Some other modes of treatment available are:
- Hydroquinone cream helps to take the pigment out of the skin by blocking the process that leads to the formation of skin pigment melanin.
- Chemical peels are used to treat the dark patches on face. The cream causes an artificial chemical burn just like sunburn. With passing weeks the burnt skin wears off and gives way to fresh skin which is free from the patches. This treatment is used only if the skin condition does not respond to the primary treatments.
- Laser melasma treatment is the most recent advancement in this field. It uses certain wave lengths of light and laser rays to treat the pigmentation on the face.
Prevention of Melasma
The best way of preventing pigmentation is to cover the face adequately when going out in the sun by wearing a mask, shades and a hat. Sun blocks or Sunscreens are very effective in such cases. The sunscreen should have an SPF (Sun Protection Factor) of at least 30. Cosmetics can be used to cover up the patches. Ladies diagnosed with this skin condition should avoid waxing as it can worsen the condition. This is not a serious skin disease and is self limiting in most cases.