MELASMA

Melasma General Information

Melasma is a facial pigmentation known as chiliasm or “the mask of pregnancy “(when present in pregnant women) and it consists in the appearance of dark-brown hyperpigmentated stains especially on the face. The maculation is confluent or punctate. This skin disorder usually affects adults, both men and women, but it is more frequent among women (in 95% of the cases). Melasma is typically for those women who follow a hormone replacement therapy or occurs as a side effect of taking oral contraceptives. It affects persons of any race, from various locations on the globe where the sun exposure is intense, especially Asians and Hispanics. However, it is more frequent among persons with a darker skin or a light brown type. In other areas of the world it is more pronounced during the summer season as a result of the exposure to the sun light. This skin disease is rarely met before puberty, only after the age of 20 and it is common in pregnant women, due to harmless and mild hormonal imbalance. Although it usually fades after one or two months after delivery, a major inconvenience is that repeated pregnancies can intensify the macules. Melasma is occasionally seen in young men who use scented soaps, after-shave balms or other toiletries and it is usually diagnosed with the help of a Wood’s lamp which is useful to distinguish the melanin excess in the epidermis from that of the dermis.Ultraviolet exposure, followed by the use of various cosmetics can also produce a pigmentation reaction to the skin. This is what specialists call a phototoxic reaction and is due to sun radiation absorbed by chemical substances (types of fragrance) on the skin.

Melasma Symptoms

The precise cause for the appearance of this skin disorder is unknown even to the specialists, Melasma has only aesthetic effects and does not cause any symptoms besides the cosmetic pigmentation. It is not associated with internal diseases or with the bad function of an organ. Responsible in developing these symptoms is the genetic predisposition. More than 30% of the persons affected by this skin disease have parents or other close relatives who also suffered of the same problem. The few symptoms are represented by dark, irregular shaped spots found on the chin, forehead, lips, nose, on the upper lip and on the upper cheek and are very easy to notice. Stimulating the melanocytes under the influence of sun rays, specifically ultraviolet and the female hormones (estrogen and progesterone), the quantity of melanin is increasing. But administrating hormone treatments at the age of menopause does not seem to have a major role in producing pigmentation. Systematically exposure to sun may determine to women with dark-brown hair or with light-brown skin a higher risk to develop these symptoms. Specialists had also noticed that persons suffering of thyroid dysfunctions are liable to this skin problem. In other rare cases, this aesthetic problem is caused by an allergic reaction to some cosmetic medicines or products. Melasma Suprarenal is a symptom of Addison's disease, particularly when exerting pressure to the tegument or as a result of minor injuries to the skin.

Melasma Treatment

Melasma can be difficult to treat in some of the cases so, if you want to avoid it from happening, you should try to minimize sun exposure on the face or to apply a face cream with a very high protection sunscreen or containing a fruit acid or alpha hydoxyacid (glycolic acid, lactic acid, Kojic acid). Over it use a make-up with sunscreen with a minimum SPF15 all day long, year-round. Consider SPF in your and moisturizer foundation. Efficient sunscreens have in their ingredients titanium dioxide and zinc oxide and specialists recommend their appliance at every two hours and not just in the morning, before you go out. And because it is not enough to protect your skin all day long, avoiding irritating products, such as strong soaps or abrasive cleaners it is strongly recommended in this case. Keeping the skin clear and washed for as long as possible is a necessity. When you wash your face, use only cosmetics for sensitive skin, like mild soaps or cleansers and other special lotions. You can also try a facial peeling with alpha hydroxyacids or repeated chemical peels with glycolic acid or Jessner solution in order to avoid Melasma to appear. This kind of treatment runs the risk of increasing the pigmentation and causing unexpected effects, but is recommended when the maculation is severe. But be sure to consult an expert first on which method is best suited for your skin type, Melasma severity case and age.

In the process of medication for Melasma, a required assistance from medical experts should be done since this disease is at very high risk. Quick destructive modalities (lasers, cryotherapy, and medium-depth chemical peels) present the risk of potential adverse effects, such as hypertrophic scars, post inflammatory hyper pigmentation and epidermal necrosis. The manner of how these modalities are used by some experienced persons give effective, safe, and much quicker results than typical methods. But more advanced and careful studies are recommended before any procedure starts. The laser or light technology is the most proven and safest way for Melasma treatment as far as skin technology treatment is concern. Though it is very expensive, it is the most trusted way of treatment. Another well promoted treatment is the use of tretinoin (trans-retinoic-acid) that gives great results as monotherapy. Despite the fact that the response to this treatment is efficient, but slow, with visible results after 6 months or later, it cannot be used during the pregnancy because it increases the skin cell turnover. It also has major secondary effects: temporary photosensitivity and paradoxical hyper pigmentation skin irritation, especially when the more effective, higher concentrations are used. Once this disease is installed, a worthwhile method is laser resurfacing that should be followed by careful sun avoidance or by the use of hydroquinone because the pigmentation could seriously aggravate. An easier and faster way to drive away the stains is to use special and suitable camouflage make-up. If you follow a hormonal contraceptive method, you might consider changing it. As in the case of giving birth, after several months the maculation usually disappears quickly, in a matter of one or two weeks.