Melasma (Chloasma)

Medically reviewed by The Dermatologists and written by Dr. Alexander Börve

Melasma, previously known as chloasma, presents as gray-brown, irregularly shaped, persistent spots on the face.

Common
Very common in people older than 30 who have been exposed to sun

• Often self-diagnosable
• Symptoms: Brown or gray-brown patches, darkening of existing moles
• Color: Typically brown or gray-brown
• Location: Anywhere on the face most exposed to the sun
• Treatment: No treatment necessary; bleaching cream, pigment laser

This skin condition is most common on the face of young women after tanning. This is because the ultraviolet (UV) light stimulates melanocytes (dark pigment imparting cells) in the skin. Sun exposure can make melasma return after fading.

The condition could also be triggered by hormones caused by contraceptive pills, hormone replacement medicine or pregnancy. This is why many people call it the pregnancy mask.

Women are more likely to get melasma than men. People with skin of color are more prone to melasma because they have more active melanocytes than those with light skin. This means that those of Latin/Hispanic, North African, African-American, Asian, Indian, Middle Eastern, and Mediterranean descent are more likely to get melasma.

In addition, people who have a blood relative who had melasma also are much more likely to get melasma.

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Symptoms

Melasma manifests itself as brown or gray-brown patches. Most people get it on their cheeks, bridge of their nose, forehead, chin, and above their upper lip. It also can appear on other parts of the body that get lots of sun, such as the forearms and neck.

Some may experience darkening of existing freckles, areolas (nipples), and moles or a dark line down the center of the abdomen, which is known as linea nigra.

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What can I do?

Even though there is no treatment for melasma, melasma may fade on its own. This often happens when the trigger is pregnancy or birth control pills. When the woman delivers the baby or stops taking the birth control pills, melasma may fade.

You can also protect the affected areas from the sun. You can wear sunscreen every and reapply it every 2 hours to achieve so. Some dermatologists also recommend wearing a wide-brimmed hat when you are outside, as sunscreen alone may not give you all the protection you need.

Some studies show that folate deficiency can be related to hyperpigmentation. Therefore, you can try including green leafy vegetables, oranges, whole-wheat bread, and whole-grain cereal to your diet. You should also stop using skin care products that irritate the skin, as it may worsen melasma.

Should I seek medical care?

If self-treatment does not improve your situation or causes skin irritation and darkening, you should seek help from a dermatologist.

Treatment

There is no treatment for melasma. Meticulous use of sunscreen, topical retinoids, azelaic acid, bleaching cream, or a pigment laser under dermatologist supervision can help reduce pigmentation. It may be take a few months of treatment to see improvement.

If you’re pregnant or breastfeeding: Don’t use peels, bleaches or other chemically based lightening treatments, since they can potentially penetrate the skin.

Source:

American Academy of Dermatology. Melasma. Available at: https://www.aad.org/public/diseases/color-problems/melasma

What to Expect. Chloasma (Mask of Pregnancy). Available at: http://www.whattoexpect.com/pregnancy/symptoms-and-solutions/chloasma.aspx

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