What exactly is melasma?

Melasma is a natural darkening of the skin caused by excessive production of melanin—melanin is the pigment that causes your skin to tan. That's why the sun, which increases melanin production, usually makes your melasma worse.

Melasma only occurs on the areas of your skin that are exposed to the sun. IT can be mild, moderate, or severe. Melasma is a peculiar disorder of the skin. In common terms this disorder is known as "the mask of pregnancy". Melasma only occurs in adult women. Typically it appears as dark pigmentation which slowly develops on the face. Melasma affects the forehead, cheek bones, upper lip and chin, which are the most common facial areas affected. Melasma can occur in any female, but women who are or have been pregnant and those on birth control pills are the most likely affected.

Who gets melasma?

Melasma is a common skin condition that occurs predominantly in women. In fact, about 6 million women are estimated to have melasma Anyone can have it, though it seems to be more common in people with light brown skin, especially Hispanics and Asians.

What causes melasma?

Melasma is caused by over-stimulation of the pigment producing cells in the skin. Although the precise mechanism is not understood, sunlight seems to interact with a woman’s hormones to over stimulate the pigment cells. The extra pigment is deposited in the skin resulting in the dark discoloration. Melasma is a harmless disorder. It is not related to cancer and it does not involve internal organs.

Treatment for melasma?

• Melasma is treated by Topical depigmenting agents, such as hydroquinone (HQ) either in over-the-counter (2%) or prescription (4%) strength. HQ is a chemical that inhibits tyrosinase, an enzyme involved in the production of melanin.
  
• Tretinoin, an acid that increases skin cell (keratinocyte) turnover. This treatment cannot be used during pregnancy.
  
• Azelaic acid (20%), thought to decrease the activity of melanocytes.
  
• Facial peel with alpha hydroxyacids or chemical peels with glycolic acid helps treat melasma.
  
• Laser treatment. A Wood's lamp test should be used to determine whether the melasma is epidermal or dermal. If the melasma is dermal, laser (or "IPL") will acually DARKEN and worsen the appearance of the spots. Dermal melasma is generally unresponsive to most treaments, and has only been found to lighten with products containing mandelic acid.
  
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