Melasma Information - Symptoms and Treatment

Melasma, appears as a blotchy, brownish pigmentation on the face that develops slowly and fades with time. Melasma is a skin condition presenting as brown patches on the face of adults. Both sides of the face are usually affected. The most common sites of involvement are the cheeks, bridge of nose, forehead, and upper lip. Melasma mostly occurs in women. Only 10% of those affected are men. Dark-skinned races, particularly Hispanics, Asians, Indians, people from the Middle East, and Northern Africa, tend to have melasma more than others. It also occurs as a side-effect of taking contraceptive pills and injected depot contraceptive preparations. It may also be noticed in apparently healthy, normal, non-pregnant women where it is presumed to be due to some mild and harmless hormonal imbalance.

Treatment of Melasma

Following are the treatment for Melasma:

The mainstay of treatment remains topical depigmenting agents. Hydroquinone (HQ) is most commonly used. It is a hydroxyphenolic chemical that inhibits tyrosinase, leading to the decreased production of melanin.

The use of tretinoin ( trans- retinoic-acid) can be effective as monotherapy. However, the response to treatment is less than with HQ and can be slow, with improvement taking 6 months or longer. As such, combinations of tretinoin with HQ, with or without a topical corticosteroid, have been promoted.

Azelaic acid, available as a 20% cream-based formulation, appears to be as effective as 4% HQ and superior to 2% HQ in the treatment of melasma.

Other depigmenting agents that have been studied in the treatment of melasma are 4- N -butylresorcinol, phenolic-thioether, 4-isopropylcatechol, kojic acid, and ascorbic acid.

In severe cases, laser treatments can be used to remove the dark pigment.

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