Melasma is also known as Chloasma faciei or the mask of pregnancy (when it appears on pregnant women) and is a tan or dark skin discoloration that typically develops in the summer months. The name comes from Melas which is the Greek word for black.
Even though the condition can affect anyone Melasma is most common in women 20 to 50 years of age and especially pregnant women and those taking hormone replacement therapy or oral or patch contraceptives. Melasma is caused partly by sun, genetic predisposition, and hormonal changes. The incidence of Melasma increases in individuals with thyroid disease.
Overexpression of the tyrosine kinase receptor c-kit and certain stem cell factors have been identified in Melasma lesions and fibroblasts located in the dermal layer of the skin may also contribute to the development of Melasma. A dermatologist may examine the skin using a Wood’s light to see how deeply the melasma penetrates the skin. People with olive or darker skin like Hispanic, Asian, and Middle Eastern individuals are at higher risk for contracting Melasma. The condition is not an infection, it’s not contagious, it’s not due to an allergy, and it’s not cancerous.
Symptoms of melasma may include brown or gray-brown patches on the face that appear on the forehead, cheeks, chin, bridge of the nose, above the upper lip, and on the forearms or neck.
There are many causes that go into patients developing melasma. Anyone can develop this skin condition, but those who are young, female and have a darker skin tone are the most likely to get it. Fluctuations in female hormones are often considered to be the main cause of this condition. When progesterone and estrogen levels change, it can trigger this condition. This can include getting hormone replacement therapy after menopause or taking oral contraceptives.
Another risk factor is sun exposure. People who live in hot, sunny climates are more likely to develop this skin condition. There may also be a genetic component to melasma. Some sufferers may have a genetic predisposition to developing it. Having a thyroid condition can make one more prone to this condition. Being stressed can trigger the body to make too much of the melanocyte-stimulating hormone, and this can cause melasma. In some cases, cosmetics or medicines can trigger an allergic reaction, and this can lead to the development of melasma. For patients with Addison’s disease, melasma is generally one of the symptoms.
Treatment includes: Hydroquinone, tretinoin and corticosteroid cream; Azelaic acid, oral tranexamic acid, chemical peels, microdermabrasion, cosmetic camouflage, strict avoidance of the sun, stopping hormone medicines that may be causing the problem, and laser treatments can help lighten the skin.
Because the sun is responsible for so many cases of melasma, it’s important to avoid too much direct sunlight on the face to prevent this condition. Using sunscreen or seeking out shade can help to avoid these brown patches. Wearing a hat regularly when outdoors and avoiding the sunniest parts of the day, from 10 a.m. to 2 p.m., can also be helpful. When choosing your sunscreen, look for products that will protect your skin from both UVA and UVB radiation. The SPF of the sunscreen should be at least 30. If you are very fair, choose a higher-level sunscreen with an SPF of 70 or more. If the condition is caused by oral contraceptives, talk to your doctor about changing to a different medication. There may be one that won’t trigger this condition for your skin.