(Chloasma; Mask of Pregnancy)
Pronounced: mah-LAZ-maEn Español (Spanish Version)
Melasma is brown patches that appear on the skin. These patches usually appear on the cheeks, nose, forehead, chin, and upper lip. Patches can also appear on the neck and forearms. The brown patches are due to an increased amount of pigment (melanin) in the skin.
Common Site for Melasma
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The exact cause is unknown. The condition is thought to be associated with hormones such as estrogen and progesterone. Sun exposure also plays a major role.
Risk factors include:
- Being a woman of reproductive age
- Having a darker skin tone
- Getting too much sun exposure
- Taking birth control pills
- Using products that irritate the skin (eg, cosmetics)
- Taking certain medicines (eg, antiseizure medicines, hormone therapy)
- Family history of melasma
The only sign of melasma is dark patches of skin. It is not painful or itchy. If you have brown patches on your skin, do not assume they are due to melasma. They may be caused by other conditions. Tell your doctor about your symptoms.
Your doctor will ask about your symptoms and medical history. Your skin will be examined. He may use a lamp, called a Wood’s lamp, to look at your skin. In some cases, your doctor might take a small sample of skin for a biopsy to confirm the diagnosis.
If melasma is caused by pregnancy, taking birth control pills, or hormone replacement therapy, it may slowly fade somewhat after giving birth or stopping the medicine. It can reappear and become darker if you become pregnant again or resume taking hormones.
If melasma does not go away, it may need to be treated. Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Ultraviolet Light Protection
One important method in helping melasma fade is ultraviolet light protection. This means avoiding sun and tanning bed exposure. Your doctor may recommend wearing sunscreen.
Depigmenting medicines, like bleaching creams, are used to lighten skin color. A common bleaching cream used to treat melasma is hydroquinone . This may also be used with other creams (eg, tretinoin , corticosteroids, azelaic acid or glycolic acid) to enhance the skin-lightening effect. Since your skin may be sensitive to these medicines, use care and start slowly when first using them. It may take several months before you see an improvement.
Other treatments remove outer layers of the skin. Examples include:
|Treatment||Layers Removed by:|
|Chemical peel||Chemical solution|
|Microdermabrasion||Sandblasting with aluminum oxide micro crystals|
|Laser therapy||Laser rays|
Along with treatment, avoid using products that can irritate your skin. These include make-up, creams, and cleansers.
To help reduce your chance of getting melasma, take the following steps:
- Limit the amount of time you spend in the sun. Also, avoid using tanning booths.
- Use sunscreen daily. Wear sunscreen that protects against both UVA and UVB rays and has an SPF of 30 or more. Also, sunscreens containing zinc oxide and titanium oxide can be very helpful for protecting your skin against melasma.
The American Academy of Dermatology
Canadian Dermatology Association
Gupta AK, Gover MD, Nouri K, Taylor S. The treatment of melasma: a review of clinical trials. J Am Acad Dermatol . 2006;55(6):1048-1065.
Melasma. American Academy of Dermatology website. Available at: http://www.aad.org/public/publications/pamphlets/common_melasma.html . Accessed December 15, 2010.
Melasma. American Osteopathic College of Dermatology website. Available at: http://www.aocd.org/skin/dermatologic_diseases/melasma.html . Accessed December 15, 2010.
Melasma. Familydoctor.org website. Available at: http://familydoctor.org/online/famdocen/home/common/skin/disorders/982.html . Created November 2009. Accessed December 15, 2010.
Prignano F, Ortonne JP, Buggiani G, Lotti T. Therapeutical approaches in melasma. Dermatol Clin . 2007;25(3):337-342.
Tierney EP, Hanke CW. Review of the literature: Treatment of dyspigmentation with fractionated resurfacing. Dermatol Surg . 2010 Oct;36(10):1499-508.
Last reviewed January 2011 by Ross Zeltser, MD, FAAD
Last updated Updated: 1/18/2011
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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