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Melasma - Causes, Symptoms and Treatment


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Melasma is a tan or dark facial skin discoloration. Melasma is thought to be the stimulation of melanocytes or pigment -producing cells by the female estrogen and progesterone to produce more melanin pigments when the skin is exposed to sun. Although it can affect anyone, melasma is particularly common in women, especially pregnant women and those who are taking oral contraceptives or hormone replacement therapy medications. Women with a light brown skin type who are living in regions with intense sun exposure are particularly susceptible to developing this condition. It can be mild, moderate or severe, depending on how much of your face is discolored and how much darker than normal your skin has become. The brownish discoloration of the face is usually seen over the sun - exposed areas such as cheeks, forehead, nose or upper lip. Melasmapresents itself in one of the three usually symetrical facial patterns. The most common is a centrofacial pattern involving the cheeks, forehead, upper lip, nose, and chin. Less common are the malar pattern, involving the cheeks and nose, and the mandibular pattern, involvong the ramus of the mandible.

Melasma may also be associated with the use of certain anti-epileptic drugs. In many cases, it occurs without any of these predisposing factors and is occasionally seen in men. The keys to melasma prevention and treatment are sun avoidance and skin lightening products. The incidence of melasma also increases in patients with thyroid disease. It is thought that the overproduction of melanocyte-stimulating hormone brought on by stress can cause outbreaks of this condition. The discoloration usually disappears spontaneously over a period of several months after giving birth or stopping the oral contraceptives or hormone replacement therapy. Cosmetic cover-ups can also be used to reduce the appearance of melasma. Aside from or in addition to the depigmenting creams, a dermatologist may employ other techniques. Chemical peels, microdermabrasion, and even some lasers can be effective treatments. In all treatments, avoidance of exposure to sun is required. Tretinoin, bleaching cream or laser treatment cannot be used during pregnancy. In case of severe melasma, you should call your health care provider as soon as possible.

Causes of Melasma

Melasma is usually caused by normal hormonal changes in women. Genetic predisposition is also a major factor in determining whether someone will develop melasma. Other rare causes of melasma include allergic reaction to medications and cosmetics. Sun exposure is also another strong risk factor for melasma. A few cases within families suggest that melasma should not be considered as a heritable disorder. It can be arise from deficiency of nutritional, genetic factors, hepatic dysfunction and medications.

Common causes and risk factors of Melasma:

  • Mask of pregnancy.
  • Genetic predisposition.
  • Allergic reaction to medications and cosmetics.
  • Sunlight is a major factor.
  • Oral contraceptives.

Signs and Symptoms of Melasma

The symptoms of melasma are dark, irregular patches commonly found on the upper cheek, nose, lips, upperlip, and forehead. These patches often develop gradually over time. The condition occurs more frequently in association with pregnancy. Melanin (the skin's pigment) is deposited in excess in the skin's upper layer. There is no other symptoms are found in case of severe melasma.

Sign and symptoms may include the following :

  • Discoloration of skin.
  • Tan, dark brown patches.
  • Symmetrically distributed on the forehead, cheeks, and sides of the nose.
  • Irregular in shape.

Treatment for Melasma

The best treatment for melasma is prevention. The key to preventing melesma is to avoid the sun exposure and make a rule to apply sunscreen while moving out. However for the ones whom it's too late for prevention a number of treatment options are available. In all of these treatments the effects are gradual and a strict avoidance of sunlight is required. The use of broad-spectrum sunscreens with physical blockers, such as titanium dioxide and zinc dioxide is preferred over that with only chemical blockers. Another skin lotion, Tretinoin or Retin-A, increases the skin's acidity so new skin cells develop more quickly. This treatment cannot be used during pregnancy as it is deemed unsafe to the fetus.

Treatment may include:

  • The most common treatment is a prescription bleaching cream used with or without the antiwrinkle cream Renova and the anti acne cream Azelex .
  • Lasers that specialize in removing brown pigment are also used to remove melasma.
  • Use Retin-A cream to the affected area before going to the bed, it is effective and safe treatment for melasma.
  • Wearing sunscreen on a regular basis helps to prevent melasma from becoming worse.
  • Camouflage cosmetics approach is also beneficial for treatment of melasma.
  • Laser treatment may be helpful to remove the skin discoloration.