What is Melasma?

Melasma (a term derived from the Greek word melas = black spot) is an acquired, spotted, irregularly shaped gray or sometimes brownish hyperpigmentation of the face, or sometimes neck, the etiology of which is not yet fully known, but can be attributed in the action of solar radiation and in genetic predisposition.

How is it caused?

As mentioned above, the exact cause of the melasma is unknown. However, the disease may be associated with pregnancy, birth control pills, certain medications or may eventually be idiopathic. The use of cosmetics with specific ingredients, as well as photosensitive agents are often blamed for the appearance of the melasma. Also, the role of sunlight is very important.

Melasma outbreaks are inevitable after reckless exposure to the sun, and vice versa, there is a remission of the disease in periods of avoidance of sun exposure.

The number of pigmented spots ranges from one to multiple and are located symmetrically, mainly on the forehead, cheeks, back of the nose, upper lip, chin and sometimes the neck.

How is it treated?

The melasma is histologically classified into three types: epidermal, chorionic and mixed. The importance of the above classification is very important for prognosis. Patients with skin type melasma respond much better to treatment.

Melasma is an aesthetic problem. Most therapies may temporarily discolor the melasma, but the condition usually recurs. Before deciding on the treatment regimen for melasma, the factors associated with the pigmentation disorder should be considered.

Exposure to sunlight should be avoided. Wide-spectrum sunscreens should be used, as melanin cells in the melasma are activated not only by UVB, BUT ALSO uva, and visible radiation. The sunscreen should be applied daily during the treatment and continued when it is finished, all the months of the year with sunshine, for a long time. Sunbathing is strictly forbidden, as a few minutes of sunbathing can reverse the positive effect of months of treatment.

Melasma may disappear automatically within months after delivery or after discontinuation of birth control pills. Recommended treatments include whitening agents, chemical exfoliation, treatments with laser, and others, for which the dermatologist is solely responsible.

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