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Melasma—A Discoloration on the Face and Forehead

26 August 2010

Melasma is the discoloration commonly found on the upper cheek, nose, lips, upper lip, and forehead in women and men. It is also known as "Chloasma faciei" or the mask of pregnancy when present in pregnant women. It is a tan or dark skin discoloration. Although it can affect anyone, melasma is par ticularly common in women, especially pregnant women and those who are taking oral or patch contraceptives or hormone replacement therapy (HRT) medications. It is also prevalent in men and women of Native American descent (on the forearms) and in men and women of German/Russian and Jewish descent (on the face).

The symptoms of melasma are dark, irregular patches commonly found on the upper cheek, nose, lips, upper lip, and forehead. These patches often develop gradually over time. Melasma does not cause any other symptoms beyond the cosmetic discoloration.

Melasma is thought to be caused by the stimulation of melanocytes or pigment-producing cells by the female sex hormones estrogen and progesterone to produce more melanin pigments when the skin is exposed to sun. Women with a light brown skin type who are living in regions with intense sun exposure are par ticularly susceptible to developing this condition. The discoloration usually disappears spontaneously over a period of several months after giving bir th or stopping the oral contraceptives or hormone replacement therapy.

Genetic predisposition is also a major factor in determining whether someone will develop melasma.

The incidence of melasma also increases in patients with thyroid disease. It is thought that the overproduction of melanocyte-stimulating hormone (MSH) brought on by stress can cause outbreaks of this condition. Other rare causes of melasma include allergic reaction to medications and cosmetics.

Melasma Suprarenale (Latin—above the adrenals) is a symptom of Addison's disease, particularly when caused by pressure or minor injur y to the skin, as discovered by Dr. FJJ Schmidt of Rotterdam in 1859.

Melasma is usually diagnosed visually or with assistance of a Wood's lamp (340 - 400 nm wavelength). Under Wood's lamp, excess melanin in the epidermis can be distinguished from that of the dermis.

There are many treatments to hasten the fading of the discolored patches such as topical depigmention agents; an acid that increases skin cell turnover; one that decreases the activity of melocytes; facial chemical peels, laser treatments and intense pulsed light.

At Miramar Dermatology, the physicians per form the Melanage Peel. "The Melanage system has revolutionized the way we treat our patients with melasma. Our success rate is much better now that we have this modality" says Dr. Gottlieb.

-By Anita Finley

Listen to Dr. Gottlieb and Anita Finley on Saturday, September 11th from 7:00-7:30 AM on WSBR 740AM and on the Internet at www.wsbrradio.com

Anita Finley @ 12:38
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Melasma—A Discoloration on the Face and Forehead

Listen to Dr. Gottlieb and Anita Finley on Saturday, September 11th from 7:00-7:30 AM on WSBR 740AM and on the Internet at www.wsbrradio.com

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