Melasma, also commonly called chloasma or “the mask of pregnancy” when it occurs in women, is a skin condition marked by large areas of darkening on the skin of the face. The tan or brown markings can appear on the forehead, cheeks and jaw and in certain rare cases may also occur on the forearms.
There are no other symptoms beside discoloration but the discoloration can be marked enough to cause embarrassment. The condition occurs almost entirely among women, though it can also occur in men, and is more common among individuals with brown or olive skin tones such as Hispanics and Asians. Because it is closely connected with imbalances in hormone levels, it tends to occur most commonly in women in their reproductive years.
What causes melasma to occur?
There are several known triggers for this condition. Pregnancy (mask of pregnancy) is the most common cause of melasma.
Though the exact mechanism that causes this condition is unknown, scientists have been able to pinpoint a connection between it and increased levels of progesterone. This finding has been further solidified by the fact that women who are taking oral contraceptives are at risk of developing melasma.
Sunlight is a major factor in the development of melasma as well. In fact, increased sun exposure is thought to be the primary trigger for this as well as other skin disorders. The more time you spend in the sun, the more you increase your likelihood of developing a severe case of melasma.
This is why people with light brown skin from regions of the world that have increased sun exposure are most likely to develop the condition. While an exact cause has yet to be determined, genetics and hormone level fluxuations combined with sun exposure are the most likely candidates.
What are the best treatments for melasma?
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. Dermatologists may recommend other types of topical medications including tretinoin to help lighten the skin and diminish the appearance of melasma.
Retin-A cream applied to the entire face each night before bed has been shown to be an effective treatment for melasma.
If you have this condition, 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.
Recent studies have been undertaken to determine the efficacy of combining topical treatments with mild surgical treatments including microdermabrasion and laser therapy. So far, the results have been limited since these types of surgical treatments are known to have serious side effects including permanent discoloration of the skin and scarring.
No matter what type of treatment you use, a strong sun screen such as Shade Lotion SPF 45 should be applied to the face each morning. Continued protection from sun exposure is critical both to help clear up symptoms and to prevent recurrence.
Discuss your condition with a dermatologist to determine the best melasma treatment for you.