Melazma

Description of Melasma

Melasma (Greek for “black spot”) is an acquired hyperpigmentation of varying darkness, usually appearing in sun-exposed areas, most commonly on the face, as a consequence of sunburn.

Causes of the Condition

The causes of the condition are not known, but it is observed that melasma occurs more frequently during pregnancy or when taking oral contraceptives.

Symptoms

It mostly affects young adults, more commonly women than men. Typically, after sun exposure, hyperpigmented spots ranging from light to dark brown (sometimes even black) appear, spreading and darkening quite rapidly – within a few weeks. Their edges are jagged and uneven. The face is usually affected symmetrically on both sides, with the cheeks, forehead, nose, upper lip being the most commonly affected areas. Occasionally, the upper parts of the forearms are also affected.

Melasma is a cosmetic issue that does not pose a threat to life or health, but it is a significant psychological problem for both men and women.

Diagnosis

Diagnosis is based on clinical signs, ruling out other possible causes of increased pigmentation. No additional tests are necessary.

Prognosis

Melasma may disappear on its own after a few months postpartum or after discontinuing oral contraceptives. Additionally, melasma may recur during subsequent pregnancies, but not necessarily.

Treatment

Melasma is treated with topical preparations containing hydroquinone, azelaic acid, tretinoin, glycolic acid. Effective chemical face peels with fruit acids, glycolic acid, salicylic acid, lactic acid are also used.

Laser treatment is also applied.

In severe cases, cosmetic camouflage can be used to conceal melasma.

Prevention

To prevent melasma, it is recommended to apply sunscreen with titanium dioxide, zinc oxide every morning.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology