Melasma...Do not treat Melasma!!!
Overview
Melasma (also known as chloasma or the mask of pregnancy when present in pregnant
women) is a tan or dark facial skin discoloration. Although it can affect anyone, melasma is
particularly common in women, especially pregnant women and those who are taking oral
contraceptives or hormone replacement therapy (HRT) medications. The ratio of female to
male is 9:1 and is more common in yellow to brown skin color ( Fitzpatrick's skin photo
type III to V) .The lesions usually develops in middle age and persists for many years. In
post menopause women, the lesions usually fade spontaneously. Prolong exposure to
sunlight is the most important etiologic factor. It is also prevalent in men and women of
Native American descent (on the forearms) and in men and women of German/Russian
Jewish descent (on the face).
Symptoms
The symptoms of melasma are brown to dark brown, irregular patches commonly found on
the mid-face, upper cheek, nose, lips, upper lip, and forehead. Early lesions have well
defined irregular margin, while older lesions tend to be grayish brown color with irregular
and ill-defined border. These patches often develop gradually over time. Clinically melasma
had been divided into two clinical types 1) centro-facial and 2) zygoma types. Melasma
does not cause any other symptoms beyond the cosmetic discoloration.
Cause
Melasma is thought to be the stimulation of melanocytes or pigment-producing cells by the
female sex hormones estrogen and progesterone to produce more melanin pigments when
the skin is exposed to sun. Women with a light brown skin type who are living in regions
with intense sun exposure are particularly susceptible to developing this condition.
Genetic predisposition is also a major factor in determining whether someone will develop
melasma. Recent study of pathology changes of melasma had revealed that majority of
melasma also had increase in number of melanocytes. The average increase is about 30%
together with proliferation of small blood vessels in the dermis. Melanin dropping into
dermis together with presence of macrophages containing melanin (melanophages) are
commonly found in long standing cases. These three findings may explain the chronicity of
melasma. Proliferate and dilated blood vessels may contribute to chronicity by being the
source of cytokines ,prostaglandins and leukotrienes that stimulate melanin synthesis.
Summary of Contents for Skin classic
Page 7: ...Telangiectasia Description with Pictures Evaluation Treatments Prognosis ...
Page 21: ...Flat Hyperpigmentation Descriptionwith pictures Evaluation TreatmentsPrognosis ...
Page 29: ...Skin Tags Description with pictures Evaluation Treatments Prognosis Skin Tag ...
Page 35: ...Melasma Description with pictures Evaluation Treatments Prognosis ...