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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)
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
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.