4. MELASMA (CHLOASMA)
• Melasma is an acquired hypermelanosis of sun-exposed
areas.
• Chloasma is a synonymous term sometimes used to
describe the occurrence of melasma during pregnancy.
• Chloasma is derived from the Greek
word chloazein,meaning "to be green." Melas, also Greek,
means "black." Because the pigmentation is never green in
appearance, melasma is the preferred term.
6. PATHOPHYSIOLOGY
• Melasma risk increases with increasing sun exposure,
the mechanism probably involves overproduction of
melanin by hyperfunctional melanocytes.
• Other than sun exposure, aggravating factors include
• Autoimmune thyroid disorders
• Photosensitizing drugs
7. PATHOPHYSIOLOGY
• Sun exposure: Ultraviolet (UV) light from the sun stimulates the
melanocytes. In fact, just a small amount of sun exposure can
make melasma return after fading. Sun exposure is why
melasma often is worse in summer. It also is the main reason
why many people with melasma get it again and again.
• A change in hormones: Pregnant women often get melasma.
When melasma appears in pregnant women, it is called
chloasma, or the mask of pregnancy. Birth control pills and
hormone replacement medicine also can trigger melasma.
• Cosmetics: Skin care products that irritate the skin may worsen
melasma.
8. MELASMA PRESENTATION
• Melasma consists of dark brown or (It causes brown
to gray-brown patches), sharply marginated, roughly
symmetric patches of hyperpigmentation on the face
• (usually on the forehead, temples, cheeks, upper lip,
or nose).
• Some people get patches on their forearms or neck.
This is less common.
9.
10. MELASMA RISK FACTORS
It occurs primarily in
• Pregnant women
• Women taking oral contraceptives.
• Dark-skinned men.
11. RISK FACTORS
• Melasma appears on women’s skin much more often
than men’s skin. Just 10% of people who get melasma
are men.
• People who have a blood relative who had melasma also
are much more likely to get melasma.
• In women, melasma fades slowly and incompletely after
childbirth or cessation of hormone use.
• In men, melasma rarely fades.
12. DIAGNOSIS
• Dermatologists can diagnose most patients by looking at
their skin. By a device called a Wood’s light.
• To rule out another skin condition may need to remove a
small bit of skin. This procedure is called a biopsy
13. TREATMENT
• Melasma can fade on its own.
• If the melasma does not go away or a woman wants to
keep taking birth control pills, melasma treatments are
available.
• These include:
14. HYDROQUINONE:
• This medicine is a common first treatment for
melasma.
• It is applied to the skin and works by lightening the
skin. It’s came as a cream, lotion, gel, or liquid.
15. TRETINOIN AND CORTICOSTEROIDS:
• To enhance skin lightening, dermatologist may
prescribe a second medicine.
• This medicine may be tretinoin or a
corticosteroid.
• Sometimes a medicine contains 3 medicines
(hydroquinone, tretinoin, and a corticosteroid) in
1 cream. This is often called a triple cream.
16.
17. OTHER TOPICAL (APPLIED TO THE
SKIN) MEDICINES:
• Dermatologist may prescribe azelaic acid or kojic
acid to help lighten melasma.
19. OUTCOME
• Under a dermatologist’s care, many people with
melasma have a good outcome.
• Patient can help prevent melasma from returning by
wearing sunscreen and a wide-brimmed hat every day.
20. MANAGING
Patient should:
• Wear sunscreen daily
• Wear a wide-brimmed hat outside
• Choose gentle skin care products
• Avoid waxing
