Melasma is a common skin condition in which patches of skin on the face darken with a mottled appearance. Typically, the affected areas are the cheeks, bridge of the nose, forehead or upper lip but it can also occur on the arms. The dark patches are often symmetrical. Melasma can occur in both men and women although only 10 percent of cases are in men. It is especially common in women who are pregnant and is sometimes referred to as the “pregnancy mask.” Melasma is a benign condition but it can be extremely distressing for individuals afflicted due to the alteration of appearance. It may disappear in a woman several months after she gives birth, but may reoccur after unprotected exposure to the sun.
While the precise cause of melasma is unknown, certain individuals have a genetic predisposition to developing this condition and there is a clear correlation between female hormones and melasma. Women on birth control, or hormone replacement are much more susceptible. Sun exposure makes the development of melasma more likely, makes the patches more visible and harder to get under control. so women in tropical climates are more prone to the condition. Sometimes but not always, patients may achieve symptom relief if they stop taking estrogen and progesterone, the hormones linked to the disorder. However, sun avoidance may be the best treatment in conjunction with topical skin-bleaching agents, chemical peels, laser treatment/Intense pulsed light (IPL) therapy, microdermabrasion or dermabrasion. When UV exposure can not be avoided, patients who desire improvement should wear a UVA/UVB sunblock such as zinc oxide.