Understanding Melasma: Causes, Prevention & Treatment
For many pregnant women there are more changes than simply gaining weight and hormone imbalances involved in carrying a baby for nine months. Many women will experience darkening of the facial hair, which is simply treated by bleaching cream such as Jolen cream. However, other women also experience a change in the pigmentation of the skin or increased production of melanin causing skin discoloration.
This is known as Melasma, Chloasma or “the mask of pregnancy” and is defined as the tanning or darkening of facial skin. Melasma does not only occur in pregnant women but can also appear in those taking an oral or patch contraceptive. In addition, women taking HRT (hormone replacement therapy) medication can also have an increased risk of melasma.
Dark Spots and Discoloration
Symptoms include dark irregular patches on the:
- cheeks
- nose
- lips
- forehead
The appearance of melasma is gradual over time, with no other symptoms. The cause of this condition is due to the stimulation of melanocytes or pigment producing cells affected by estrogen and progesterone. These are naturally occurring female hormones which can affect the melanin pigments when skin is exposed to the sun. The increase of MSH or melanocyte stimulate hormone is the main culprit.
As stated before pregnant women are not the only people affected by Melasma. It is common in those with light brown skin and living in areas of intense sun exposure. There are also genetic dispositions and an increase of cases in patients with thyroid disease. In rare occasions Melasma is experienced due to allergic reactions from medication and or cosmetics. This condition is diagnosed by a dermatologist with the use of a woods lamp which detects excess melanin in the epidermis.
Treatment of Melasma
There are methods of treatment which can correct this discoloration. Often after pregnancy, the spots will often disappear spontaneously or after stopping the use of oral contraceptives and HRT medications. Other treatments for melasma can include the use of a topical depigmenting agent. Such medications can include hydroquinone (HQ), which inhibits an enzyme which produces melanin. This can be found in products like Tri Luma skin cream.
Facial acids (such as tretinoin) can increase skin cell turnover but cannot be used during pregnancy. Other acids, such as azelaic acid or facial peels using alpha hydroxy acids, have shown effectiveness. The use of laser treatment may or may not be effective, depending on the diagnosis. If the melasma is dermal, lasers will darken or worsen the discoloration. Dermal melasma can only be lightened with mandelic acid.
Other skin conditions such as hypermelanosis or hyperpigmentation are also caused by sun exposure and create skin discoloration. These can be diagnosed by a dermatologist and treated similarly. With skin conditions the best tip or remedy to problem is prevention. Caring for your skin should include minimizing sun exposure and using a high quality SPF. There are also cosmetics you can easily use which contain SPF for daily skin care health and beauty. If you have skin discoloration, plan a visit to your dermatologist and have a clear diagnosis made. Melasma is nothing to fear and is not much more than an inconvenience!
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