Melasma(Chloasma)

                                                     Melasma(Chloasma)

 Melasma is a common skin problem. It causes ti gray-brown patches, usually on the face. Most people get it on their cheeks, bridge of their nose, forehead, chin, and above their upper lip. It also can appear on the parts of the body that get lots of sun, such as the forearms and neck. 

     An acquired hypermelanosis with blotchy coalescent hyperpigmented macules occurring in sun-exposed areas, especially of the face and neck, which is typically seen in pregnancy or with OC use, it is caused by oxidation of tyrosine to melanin and usually regresses with delivery. A similar mask may appear in men whit out abnormal hormone levels, and in patients treated with phenytoin. 

     One of the most common treatments for melasma is sun protection. This means wearing sunscreen every day and reapplying the sunscreen every 2 hours. The dermatologist also recommends wearing a wide-brimmed hat when you are outside. Sunscreen alone may not give you the protection you need. Women are far more likely than men to get melasma. It is so common during pregnancy that melasma is sometimes called the mask of pregnancy. Hormones seem to trigger melasma. 

Causes:

   Melasma appears on women's skin much often than men's skin. Just 10% of people who get melasma are men. 

   People with darker skin, such as those of Latin/ Hispanic, North Africa, Africa- American, Asian, Indian, Middle Eastern, or Mediterranean descent are more likely to get melasma. People who have a blood relative who had melasma also are much more likely to get melasma. 

      What causes melasma is not yet clear. It likely occurs when the color- making cells in the skin produce too much color. People with skin of color are more prone to melasma because they have more active melanocytes than people with light skin. 

Triggers:

 Sun exposure: 

  Ultraviolet light from the sun stimulates the melanocytes. I fact just a small amount of sun exposure can make melasma return after fading. Sun exposure is why melasma often is worse in summer. It also is the main reason why many people with melasma get it again and again. 

Change in Hormones:

  Pregnant women often get melasma. When melasma appears in pregnant women, it is called chloasma, or the mask of pregnancy. Birth control pills and hormone replacement medicine also can trigger melasma. 

Signs & Symptoms:

 Common signs of melasma are brown or gray-brown patches on the face. These patches most commonly appear on the:

- Cheeks

- Forehead

- Bridge of the nose

- Above the upper lip

- Chin.

   Some people get patches on their forearms or neck. This is less common. Melasma does not cause any symptoms. But many people dislike the way melasma makes their skin look. If you dislike these patches, sun protection and treatment can help. 

Melasma types:

 Chloasma Gravidarum:
  
    Brownish pigmentation of the face, often occurring in pregnancy. It usually disappears after delivery. It is also seen in some women who take progestational oral contraceptives. mask of pregnancy.

Chloasma hepaticum:

 Liver spot. 

Idiopathic chloasma:

 Chloasma caused by external agents such as sun, heat, mechanical means, and x- rays. 

Chloasma Traumaticum:

 Skin discoloration following trauma.

Diagnosis:

   Diagnose most patients by looking at their skin. To see how deeply the melasma penetrates the skin, your physician may look at your skin under a device called a Wood's light. Sometimes melasma can look like another skin condition. To rule out another skin condition, your dermatologist may need to remove a small bit of skin. This procedure is called a skin biopsy. A dermatologist can safely and quickly perform a skin biopsy during an office visit.

Wear sunscreen daily:

   One of the most common treatments for melasma is sun protection. Since sunlight triggers melasma, it is important to wear sunscreen every day, even on cloudy days and after swimming or sweating.

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