The symptoms of melasma are dark, irregular well demarcated hyperpigmented macules to patches commonly found on clinical dermatology a color guide to diagnosis and therapy pdf upper cheek, nose, lips, upper lip, and forehead. These patches often develop gradually over time.
Melasma does not cause any other symptoms beyond the cosmetic discoloration. Melasma is also common in pre-menopausal women. It is thought to be enhanced by surges in certain hormones. Women with a light brown skin type who are living in regions with intense sun exposure are particularly susceptible to developing this condition. Genetic predisposition is also a major factor in determining whether someone will develop melasma. Other rare causes of melasma include allergic reaction to medications and cosmetics. FJJ Schmidt of Rotterdam in 1859.
The discoloration usually disappears spontaneously over a period of several months after giving birth or stopping the oral contraceptives or hormone replacement therapy. Treatments are often ineffective as it comes back with continued exposure to the sun. Assessment by a dermatologist will help guide treatment. This may include use of a Woods lamp to determine depth of the melasma pigment. This treatment cannot be used during pregnancy.
Tranexamic acid by mouth has shown to provide rapid and sustained lightening in melasma by decreasing melanogenesis in epidermal melanocytes. Either in an aesthetician’s office or as a home massager unit. Evidence-based reviews found that the most effective therapy for melasma includes a combination on topical agents. In all of these treatments the effects are gradual and a strict avoidance of sunlight is required. The use of broad-spectrum sunscreens with physical blockers, such as titanium dioxide and zinc dioxide is preferred over that with only chemical blockers. Patients should avoid other precipitants including hormonal triggers.
Common skin conditions during pregnancy”. Association of melasma with thyroid autoimmunity and other thyroidal abnormalities and their relationship to the origin of the melasma”. Systematic review of randomized controlled trials on interventions for melasma: an abridged Cochrane review”. Treatment of melasma with topical agents, peels and lasers: an evidence-based review”. Depigmentation of skin with 4-isopropylcatechol, mercaptoamines, and other compounds”. Inhibition of melanin synthesis by cystamine in human melanoma cells”. Efficacy of combination of glycolic acid peeling with topical regimen in treatment of melasma”.