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  Melasma

Melasma is a common skin condition that appears as a dark skin discoloration found on sun-exposed areas of the face. Melasma is also known as chloasma and in pregnant women it is known as the “mask of pregnancy.”

Melasma Skin diseases
Melasma


Melasma can affect anyone, but is more common in women who are pregnant or taking HRT medication (Hormone Replacement Therapy). It is also prevalent in men and women of Native American descent and German/Russian descent.

Symptoms

The symptoms of this disease are dark irregular patches of skin on the upper check, nose lips, forearms and forehead. The patches develop over tame and are harmless. Sometimes they are called liver spots or ‘cafĂ© au lait’ marks

Cause

Genetic predisposition is a factor in determining if Melasma will appear in an individual. The cause of Melasma is thought to be a stimulation of pigment production cells in the skin, which are called melanocytes. This stimulation is believed to be caused by the hormones estrogen and progesterone. These hormones produce more melanin pigments in the skin when exposed to the sun. Women with light brown skin who live in sunny climates or intensely sunny climates are susceptible to this condition, Melasma

Melasma is also more likely to appear in thyroid disease patients. The cause is believed to be the over production of progesterone and estrogen brought about by stress. Rare causes of Melasma include allergic reactions to medication and cosmetics.

Melasma is a symptom of Addison’s disease, particularly when it appears after minor pressure or minor injury to the skin.

Diagnosis:

Diagnosis of Melasma is made by visual observation using a Wood lamp. This lamp has a light wavelength of 340 to 400 nm. A Wood Lamp will expose excess melanin on the skin or epidermis that can be distinguished from that of the dermis.

Treatment:

Melasma patches will usually disappear spontaneously over a period of several months. Melasma patches can also disappear after giving birth or discontinuing hormone replacement therapy or HRT medications.

There are many treatments to increase the fade time of Melasma. Bleaching creams, also knows as topical de-pigmenting agents can be used. One agent hydroquinone (HQ) is available in over the counter strength (two percent) or prescription strength (four percent). Hydroquinone inhibits and enzyme, called tyrosinase that is linked to the production of melanin in the skin. Another treatment option is tretinoin, an acid. This product increases the shedding or turnover of old skin. Tretinoin cannot be used during a pregnancy. Azelaic acid is also a treatment that is thought to decrease the activity melanocites. Another treatment is facial peeling with alph-hydroxy-acids or glycolic acids. Laser treatments have also been used to get rid of Melasma patches.

All treatments produce gradual results and strict avoidance of sunlight is required. Broad spectrum sun screens and clothing are important. Visible lights, UV-A and UV-B will stimulate pigment or melanin production.

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