Melasma is a skin discoloration that commonly occurs in women caused by the production of too much melanin. It is characterized by brownish pigmentation or patches which form on the face, around the neck, or on the forearm. The proximate sources of Melasma are not yet known. However, there are certain circumstances that may trigger its appearance such as pregnancy, cosmetic allergy, and overuse of anti-seizure medications. It is also referred to as the â€œmask of pregnancyâ€ or chloasma because the most severe discoloration happens in pregnant women. Melasma in pregnant women may be gone a couple of months after giving birth.
The early signs of Melasma can be noticed through grayish pigmentations that start on the cheeks, forehead, bridge of the nose, above the upper lip, or the chin. Unlike freckles, Melasma are bigger, darker, and closer to each other. It forms in cluster or pattern which can further spread throughout the face.
Melasma is more common in women compared to men. It occurs in people at age 20 to 40 years old. There are three types of Melasma: epidermal, dermal, and mixed. Epidermal Melasma has a well-defined border and can easily be addressed through dermatological remedies. Dermal Melasma is the most common type, appearing as grayish with ill-defined borders. Unlike the former, it responds poorly to treatment making it more possibly to become permanent. Mixed Melasma is combination of brown and bluish patches. It is larger in pattern but can be treated gradually.
A thorough diagnosis of Melasma through skin biopsy would show a deposit of melanin in the dermis. Sometimes the melanin deposit is found in the basal area. The severity of Melasma can also be measured using a special scoring system known as Melasma Area and Severity Index (MASI).