Melasma is a distressing skin pigmentation condition that can affect any woman but it occurs more often in those with brown skin, typically between the ages of 21 and 40.
It is unclear exactly what causes melasma but it appears as darkened brown, tan or blue/grey patches and spots usually around the nose, cheeks, forehead, upper lip and chin.
There are three forms of melasma:
Epidermal - only occurs in the top layer of the skin which is treatable
Dermal - develops in the deeper layers of the skin and is not treatable
Mixed - a combination of both types so is partially treatable
Melasma most commonly occurs on the face in the center, the cheek area (malar) or jawline (mandibular), however it can also appear on other parts of the body such as the neck or forearms.
Additionally, while the cause of melasma is not known there are factors that increase the risk of developing it such as:
-- pregnancy (called chloasma or the “mask of pregnancy”)
-- use of oral contraceptives
-- hormone replacement
-- family history
-- sun exposure
-- stress which may increase the release of melanin (brownskin.net)
Treatment
Melasma that appears during pregnancy may go away on its own a few months after delivery and not need treatment. However, oftentimes it persists and may last for many years, worsening in the summer and improving in the winter.
It is very important that any treatment of melasma in ethnic skin be directed by a dermatologist who has experience in treating skin of color. Start with the American Academy of Dermatology to their “find a dermatologist section.”
Select “skin of color” for the specialty and put in your zip code. http://www.aad.org/find-a-derm
Medications that are used to treat melasma in those with skin of color include:
Hydroquine - most common
Tretinoin - Retin-A
Azelaic acid
For more difficult cases, a doctor may use glycolic acid chemical peels and microdermabrasion.
Side effects from using these medications may include skin irritation and permanent skin discoloration. This is why it is crucial to only work with an experienced dermatologist.
If melasma is thought to be due to hormonal influences such as birth control pills or hormone replacement then discontinuing use of these medications should also be explored.
Prevention
Important basic actions to prevent the worsening or recurrence of melasma after it is treated is to use a broad spectrum (UVA and UVB) sunscreen daily and avoiding the sun whenever possible by wearing hats, sunglasses and protective clothing.
Sources:
VIEWABLE VIDEO • America's Ethnic Skin: an Al Roker Health Special.
http://www.womensderm.org/ethnicskin/video/index.html
SKIN CONCERNS: Pigmentation/Melasma. Rx for Brown skin.
http://www.rxforbrownskin.com/skinconcern-pigmentation
Melasma. Dr Susan Taylor’s Brownskin.net.
http://www.brownskin.net/melasma.html
What is the treatment for melasma? Medicine.net.
http://www.medicinenet.com/melasma/page3.htm
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles
Edited by Jody Smith