Melasma is also referred to as Chloasma Faciei. The condition when affected pregnant is called as ‘mask of pregnancy’. Melasma is a skin condition in which dark brown patches and discoloration is noticed. Though the condition can affect anyone it is commonly found in women. Affected individuals may notice brown patches on the skin. In some cases women of child bearing age may suffer from bluish gray discoloration of facial skin or tanned skin, if affected with Chloasma Faciei. It is recorded that over 90% of melasma cases is attributed to women. The condition is thought to be associated with exposure to sun. However, in case of pregnant ladies hormonal variation, birth control pills, excessive sun exposure, etc are implicated causes of Chloasma Faciei. The condition is common in women ageing between 20 to 50 years of age. There are three localized pattern of patches that appears, in central face, cheekbone and jaw-line.
Causes of melasma
There is no report confirming the actual cause of the condition. Experts assume that dark patches occurring in melasma could be triggered by several factors such as pregnancy, birth control medicines, HRT (or Hormone Replacement Therapy), hereditary influences, sect, anti-seizure drugs as well as other medicines which causes skin to become vulnerable to pigmentation. However, leading cause of the condition is said to be extreme exposure to sunlight. Individuals with genetic predisposition of the condition are at increased risk of suffering from Chloasma Faciei due to excessive exposure to sunlight.
It is evaluated that most cases of melasma is recorded during summer season when sun is hottest. During winter season hyper-pigmentation cause due to this irregularity tends to be lighter and not so prominent to sight. Another possible cause of the dermatologic anomaly is excessively heated environment such as in bakery or other factories.
In case of pregnant women suffering with Chloasma Faciei, it is usually hormonal changes that lead to the condition. Increased Melanocyte-Stimulating Hormone (MSH) and increased estrogen are not considered as confirmed cause of the condition, but it is augmented amount of progesterone level that causes melasma during pregnancy. Studies indicate that women who have experienced their menopause and are receiving hormone replacement therapy for progesterone are in fact at increased risk of suffering from the condition. However, women who are taking estrogen supplements are at lesser risk of suffering from the condition. Melasma production can accelerate with use of products that may irritate and influence the skin by causing increased production of melanin.
Locations of melasma
Melasma is characterized by hyper-pigmentation especially on face as well as discolored patches. There are three types of facial pattern determined in case of melasma, which are centraofacial (center of face), malar (on cheek) and mandibular (associated with the jaw).
The condition can also appear on the upper neck region; however, it is less common. In rare cases, Chloasma Faciei may appear on other body regions such as forearms. A study confirms that this irregularity occur in forearms in people who are given progesterone supplements. This was uniquely identified in an American Study.
Types of melasma
There are four types of melasma which are dermal, epidermal, mixed and one unnamed type which is commonly found in dark skinned individuals. In dermal melasma, there is presence of melanophages in the dermis. In epidermal melasma, excessive melanin can be detected in superficial skin layer. Mixed type melasma is a condition which is combination of dermal and epidermal melasma. The fourth type of melanin can be confirmed with excessive melanocytes in dark complexioned people.
Signs and Symptoms of melasma
Melasma is highly common in women though it can also affect male individuals. In this condition there are patches appearing on the skin of affected individual that appear brownish in color. Chloasma Faciei is often characterized with its discolored patches that mostly occur on body regions that are often exposed to sunlight such as facial skin, forearms, neck, etc.
Melasma may sometimes not need advance diagnosis. In most cases it is usually recognized by the doctor through its pigmentation and pattern on the face. However, in less often cases patients are asked to go for skin biopsy. In this test a specimen of the affected skin area is taken for evaluation. It is not commonly painful as retrieval of the sample is done after anesthesia administration. The sample is evaluated under microscope and results are obtained.
There are various effective products that may be prescribed by your doctor as treatment for Melasma. The most commonly used treatment for the condition includes creams that contain 2% of hydroquinone or HQ. There are over-the-counter medicines that contain this amount of HQ for example Porcelana and Esoterica. There are other prescribed topical solutions that contain 4% HQ which may include Obagi, NeoCutis, etc. Some sunscreens as well are developed with integration of 4% HQ for example Obagi’s Sunfader sunscreen. Remember that creams that contain over 2% of Hydroquinone should be taken only after consulting a doctor.
Studies indicate that 2% HQ creams can be effective in treating melasma and is less irritating as compared to other creams that contain high concentration of HQ. These creams are usually applied twice a day and preferable before going to bed. Sunscreen should be used in the morning or before going out in sun. It is best to ask your doctor about usage of this medicine as some people may be allergic to the cream and may need medical assistance.
In some cases, wherein the condition becomes serious cosmetic concern and immediate treatment is needed, laser treatment serves has an option. However, unfortunately laser can help you gain some relief but results obtained through laser therapy are temporary. In some cases using laser technique to treat melasma may in fact aggravate the condition; hence, it should be used after thorough evaluation. In order to ensure that treatment works properly it is essential to prevent exposure to sun. Treating melasma also enhances confidence of the patient. Pregnant women should pay special attention to what treatment they use. In fact, even some conventional 2% HQ creams may not be allowed for pregnant women’s use. A better option to seek medical treatment for melasma in any case is through a doctor.