Melasma is a common, asymptomatic condition of hyperpigmentation due to overactive pigment-producing skin cells (melanocytes) afflicting mostly women in their reproductive years. It is a chronic, recurring disorder affecting heavily sun-exposed areas, particularly the face.
Melasma lesions typically present as light brown-grey brown, irregularly-shaped macules and patches (small and big flat spots) symmetrically, usually along the nose bridge, upper lip, cheeks, forehead, and chin.
WHAT CAUSES MELASMA?
The pathogenesis of melasma is multifaceted; main triggers or predilections for its development include one’s UV light exposure, genetics, hormonal changes (pregnancy, oral contraceptives, hormonal treatments), and skin phototype. Additional factors contributing to the appearance of melasma include the use of photosensitizing drugs and zinc deficiency.
TREATING MELASMA
Treating melasma is challenging with frequent relapses commonplace. As causative factors are multifold, so, too, then must be the treatment plan. Caring for melasma starts with photoprotective strategies, such as sunscreen, sun avoidance, and sun-protective clothing. Topical therapy is then incorporated with the use of skin lighteners, such as hydroquinone, azelaic acid, niacinamide, kojic acid, and retinoids. Oral medications, such as Polypodium leucomotos and glutathione, are second-line agents. For those with extensive or refractory lesions, chemical peels and lasers may be considered.
