Melasma is a common skin disorder that results in dark, brown, or blue-grey patches on the skin. It is also called chloasma or the mask of pregnancy when it develops in pregnant women. Melasma appears as flat patches or freckle-like spots and commonly affected regions include the face, cheeks, upper lip, forehead, and forearms. While it can usually affect any area of the skin that is exposed to sunlight. This condition is more common in women than men, however, it can also affect men.

Types Of Melasma

There are mainly three types of melasma, and it depends on the depth of the pigment. A wood’s lamp that emits black light is used to monitor the depth of the pigment.

Epidermal Melasma: This type has a dark brown colour or well-defined border, which appears clear under black light and in most cases responds well to treatment.

Dermal Melasma: Dermal melasma has a light brown or bluish colour, a blurry border that appear no differently under black light and does not react to treatment.

Mixed Melasma: It is the most common of all three types, that has both bluish and brown patches. Usually shows a mixed pattern under blacklight and shows the mild response to treatment.

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Symptoms

Melasma causes patches of discolouration, and these patches appear darker than the skin colour. It typically develops on the face and is symmetrical, with identical marks on both sides of the face. Other regions of the body that are constantly exposed to the sunlight can also develop melasma.

Brownish coloured patches usually appear on the:

Cheeks

Forehead

Bridge of the nose

Chin

It is harmless; however, one may feel more self-conscious about the way it looks.

Causes And Risk Factors

It is not very clear as to what causes melasma. People who are dark-skinned are at high risk than those with fair skin. Estrogen and progesterone sensitivity may also cause this condition, which means a person on birth control pills, pregnancy and hormonal therapy are highly prone to melasma. Stress and thyroid disorder are also thought to be causes of this skin problem. Furthermore, constant exposure to ultraviolet rays may affect the skin cells that regulate the secretion of melanocytes pigment.

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Diagnosis

A thorough visual examination of the affected region may help the doctor to confirm melasma diagnosis. However, to rule out specific causes the dermatologist may also suggest certain tests. One such testing method is a Wood’s lamp examination, which permits the healthcare provider to look out for any bacterial or fungal infections and determine how deeply melasma has affected your skin. At times a biopsy is also performed to rule out the risk of skin cancer.

Treatment

For some women, melasma settles on its own, when it’s caused by pregnancy or birth control pills. The dermatologist may prescribe certain creams or topical steroids that may lighten the skin. If creams do not work, then chemical peels, dermabrasion and microdermabrasion are other treatment options that strip away the top layers of the skin and lighten dark patches. However, these procedures don’t assure a complete cure and a few cases of melasma can’t be wholly lightened. Regular follow-up visits and following certain skincare routines such as minimizing sun exposure and using sunscreen may reduce the risk of the melasma returning.