Chloasma; Mask of pregnancy; Pregnancy mask
Melasma is a dark skin discoloration found on sun-exposed areas of the face.
Causes, incidence, and risk factors
Melasma is a very common skin disorder. Though it can affect anyone, young women with brownish skin tones are at greatest risk.
Melasma is often associated with the female hormones estrogen and progesterone. It is especially common in pregnant women, women who are taking oral contraceptives (“the pill”), and women taking hormone replacement therapy during menopause.
Sun exposure is also a strong risk factor for melasma. It is particularly common in tropical climates.
Melasma doesn’t cause any other symptoms besides skin discoloration but may be of great cosmetic concern.
A uniform brown color is usually seen over the cheeks, forehead, nose, or upper lip. It is most often symmetrical (matching on both sides of the face).
Signs and tests
Your physician can usually diagnose melasma based upon the appearance of your skin. A closer examination using a Wood’s lamp may help guide your treatment.
A combination of tretinoin cream and a bleaching cream containing hydroquinone may be helpful in fading some types of melasma. Occasionally, your physician may add chemical peels or topical steroid creams as well. In severe cases, laser treatments can be used to remove the dark pigment.
Most importantly, however, sun avoidance and daily sunscreen use are key to avoiding melasma.
Melasma often fades over several months after stopping oral contraceptives or hormone replacement therapy or after delivering a child. It may return with additional pregnancies or use of these medications.
Calling your health care provider
Call your physician if you have persistent darkening of your face.
Daily sunscreen use not only helps prevent melasma but is crucial in the prevention of skin cancer and wrinkles.
by Arthur A. Poghosian, M.D.