Melasma

I. Definition:

Melasma or chloasma is a brownish discoloration of the face that occurs most often in women. Men can also develop this problem. The brown color often fades in winter and gets worse in the summer.

II. Cause:

• Pregnancy (mask of pregnancy) is the most common cause of melasma.
• Women who are taking oral contraceptives are at risk of developing melasma.
• Sunlight is a major factor in the development of melasma.

III. Treatment:

• Do not use skin lighteners or bleaching creams containing steroids.  These can cause permanent skin damage including permanent redness, thinning and blood vessel streaks.  Also avoid skin lighteners or bleaching creams containing mercury as this is a poison.
• A strong sun screen such as Shade Lotion SPF 45 should be applied to the face each morning.
• Hydroquinone 4% cream (available by prescription) applied to the face twice a day (in the morning before applying sun screen and later in the day) is the main treatment for melasma.
• Retin-A cream applied to the entire face each night before bed has been shown to be an effective treatment for melasma.

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