Melasma is not a disease. It is only a disorder showing patches of pigmentation resulting from increased Melanin, a pigment normally present in skin. It is usually seen as brownish or gray patches over the cheeks, nose, fore head, upper lip and chin. Though it is commonly seen in women of childbearing age, up to 10% of men may also get the condition.

Causes of Melasma

Common causes include pregnancy, use of contraceptive pills and exposure to sunlight. However, genetic factors, hormonal imbalances, certain medications, liver dysfunction, deficient nutrition may all play a role. It is not hereditary but it may run in some families. In pregnant ladies it may clear after delivery. If drugs/contraceptive pills have caused it, it may clear after stopping them.

Elaborate Tests

Usually, dermatologists diagnose Melasma by clinical examination. Examination under a special lamp helps to find out whether the pigment is nearer the surface or deep-seated. Only a small percentage of patients may require detailed workup.

Treatment

Most important thing is to avoid exposure to sun and use a good sunscreen lotion recommended by” a dermatologist to prevent further darkening of the pigment. Creams containing peeling agents (E.g., Tretinoin, Kojic acid) and bleaching agents (E.g. Hydroquinone, Azelaie acid) are used to lighten the pigment already present in the skin. Improvement can be expected after 6-8 weeks of treatment. But it may have to be continued for 6-12 months. Persons with pigment in the superficial layer of skin can expect significant improvement. Those with deep-seated pigment do not benefit much.

Other Methods of Treatment

Chemical Peels done with mild acids such as glycolic acid and some type of lasers are also being used. But in Indian skin types, there is a risk of pigmentation changes following aggressive treatment-hence such treatments should only be done in the hands of a trained dermatologist.

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