Introduction:
The term skin pigmentation defines the color of the skin. It is determined by the quantity and nature of a pigment called melanin produced by specialized skin cells called melanocytes. Skin pigmentation can commonly present in small patches, covers larger areas, or even the full body. Variations in melanin production can result in certain pigment disorders.
What Is Melasma?
Melasma is a form of hyperpigmentation also known as chloasma, that most frequently affects the face, particularly the cheeks, nose bridge, forehead, and upper lip. It can also occur on other sun-exposed areas of the body, like the forearms. Melasma can affect men, but women, especially pregnant women are significantly more likely to get it, hence the nickname 'mask of pregnancy'. Melasma usually gets worse in the summer and better in the winter as it gradually darkens and lightens. Melanin, a dark pigment, is produced and stored by melanocytes, which are cells found in the epidermis. The skin darkens because melanocytes create more melanin when they are stimulated by hormones, light, heat, UV (ultraviolet) radiation, or other environmental factors.
What Causes Melasma?
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Genetics - Between 33 and 50 percent of melasma patients report that a family member also carries the condition.
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Pregnancy - The melanocytes, which are cells that produce melanin, and are commonly found in the epidermis of the skin, are stimulated during pregnancy by endogenous hormones like estrogen or progesterone, which are present in higher amounts in pregnant women. After pregnancy, the darker color normally fades.
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Hormones - In certain people, hormones like progesterone and estrogen may be involved. It has been noted that postmenopausal women who get progesterone occasionally develop melasma. The melasma lesions most likely include higher than average amounts of estrogen receptors even if one is not pregnant.
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Birth Control Pills - Melasma has been seen in people who take estrogen and progesterone-containing oral contraceptives, which is contraceptive medication (birth control).
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Skin Care Items - A product that generally irritates the skin may probably make the melasma worse.
What Are the Types of Melasma?
Melasma comes in three different varieties:
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Epidermal Melasma - The epidermal melasma affects the top layer of skin which appears brown with distinct borders.
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Dermal melasma - Dermal melasma affects the inner dermal layer of the skin and appears as blue-gray spots.
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Mixed Melasma - Mixed melasma is commonly seen in the epidermal and dermal layers and appears as a brown-gray pigment.
What Are the Signs and Symptoms of Melasma?
Patches of discoloration are brought on by melasma. The areas are darker than the normal skin color. It often affects the face and is symmetrical, having identical marks on both sides of the face. Melasma can also form in other parts of the body that are exposed to the sun. Brownish spots commonly occur on the cheeks and other regions such as the forehead, nose bridge, and chin. Additionally, the neck and forearms may be affected. The skin may develop bluish, light brown, dark brown, or freckle-like areas due to melasma. The areas may occasionally swell up or turn red. Melasma develops on the skin in six different places, or a combination of places:
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Brachial - The shoulders and upper arms show signs of melasma.
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Centrofacial - The forehead, cheeks, nose, and upper lip all exhibit melasma.
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Lateral Cheek Pattern - Both cheeks are affected by the melasma.
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Malar - The cheekbones and nose are where the melasma is visible.
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Mandibular - The jawline displays the melasma.
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Neck - Melasma can develop on all sides of the neck in adults 50 years of age or older.
How to Diagnose Melasma?
The diagnostic options available for melasma include the following:
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Woodland Examinations - A unique form of light is held up to the skin that enables the doctor to assess the layers of skin the melasma affects and to check for bacterial and fungal diseases.
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Skin Biopsy - A biopsy is a procedure where a little portion of the skin is scraped and evaluated by a medical professional.
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Thyroid Examination - Some thyroid check-ups can be performed by a doctor in some cases as melasma and thyroid diseases are greatly associated with each other.
What Are the Treatment Options Available for Melasma?
Prescription for hyperpigmentation is important for effective treatment plan for addressing this skin condition. The treatment options available for melasma includes the following:
1. Topical Medications - A doctor may prescribe a certain combination of skin-lightening creams to melasma patients, these include:
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Azelaic Acid - This can be used as cream, lotion, or gel twice daily. It can be used safely by women who are pregnant.
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Hydrocortisone (A Topical Corticosteroid) - Hydrocortisone can be used for lightening melasma-related pigmentation. It can also reduce the possibility of dermatitis brought on by other substances.
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Hydroquinone - This medication is used topically as a cream or lotion. It is directly applied to the melasma patches for two to four months.
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Tretinoin - This medicine is a topical retinoid that is very effective but it may also be possible to get dermatitis. It is not recommended for pregnant women.
2. Oral Medications -
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Antithyroid Medications - The doctor may recommend antithyroid medications such as Methimazole which is available as a tablet or cream. It is reported to be effective in treating melasma that is resistant to Hydroquinone.
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Soybean Extract - It is believed that soybean extract reduces the amount of color that melanocytes transfer to skin cells.
3. Chemical Peels - Doctors may also recommend some chemical peels such as topic alpha hydroxy acid whichis possible to remove the outer layer of the skin (epidermis) pigmentation. This cream or chemical peel may remove the skin.
4. Other General Treatments Include -
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Stay Out of the Sun - Try to avoid being outside when the sun is at its strongest, from 10 AM to 2 PM. Instead, sit in the shade or behind a sun umbrella to reduce exposure to the sun when outside.
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Wear a Cap - Put on a wide-brimmed hat to protect the face and scalp from sun exposure.
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Choose Hormone-Free Contraceptive Pills - Choose a birth control option without hormones for lowering the risk of melasma.
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Consult a Doctor Immediately - When anyone has melasma symptoms, schedule an appointment with the doctor as quickly as possible to start treatment.Follow the appropriate treatments and management advice as doctors suggest.
Conclusion:
Although melasma is a common, typical, and safe condition, it may be annoying. If this skin condition creates a sense of self-consciousness, it may have an influence on social life. There are a few steps that can be taken to prevent problems. Dermatologists are available for solving the concerns and problems. Always pay attention to the doctor's recommendations and strictly adhere to the treatment plan.
