Melasma is a very common skin problem. It is also called as Chloasma or "mask of pregnancy" when it occurs first time in a pregnant women. Majority of the patients are females but it can also occur in males.
Its exact causation is not yet known but several triggering factors that have been identified include pregnancy, some drugs (OCP, HRT, anti seizure drugs), and sun exposure. Almost 40% of patients have affected relatives which suggest that there is a significant role of genetic predisposition in its causation.
In this light to dark brown patches appear on the face especially over the cheek bones, forehead, bridge of the nose and sometimes over the upper lip area, chin and along the jaw line. Rarely, it can also appear over the neck and forearm.
It is an asymptomatic condition and does not result in any harm. But because of visibility and cosmetic disfigurement it causes significant psychosocial and emotional distress, thereby impairing quality of life of the affected individual.
Diagnosis of Melasma is invariably clinical. Baseline MASI score can be calculated by your Doctor and only rarely skin biopsy is required in case the presentation is atypical.
Regarding its management, we now have a wide array of treatment options. These include topical depigmenting creams, oral drugs, sunscreens, chemical peels and lasers.
Protection from sunrays is very important part of the treatment. Patient needs to keep patience while undergoing treatment for it as the therapeutic response takes time. Proper treatment can result in significant lightening of the patches and sometimes complete clearance. Previously hydroquinone and steroid based topical depigmenting creams were widely prescribed but the now the focus has shifted to use of steroid and hydroquinone free depigmenting creams which are very safe for the skin. These newer preparations contain depigmenting agents like kojic acid, liquorice, arbutin, azelaic acid, resveratrol, niacinamide, ascorbic acid, tranexamic acid, glutathione and many more.
Chances of recurrence are quite high after the treatment is stopped. So a very important part of the treatment is the safeguarding of the therapeutic response by means of maintenance therapy which includes sun protective measures (wearing sunscreen and minimizing sun exposure, keeping body parts covered) and topical depigmenting creams application. Topical creams which are safe for long term use can be prescribed for maintenance therapy.
I would summaries that Melasma is very common, it significantly impairs the quality of life, successful treatment is now possible with the advances in the management, strict sun protective measures and maintenance therapy will safeguard the therapeutic response.
So, if you notice symptoms of melasma, see our doctor at Skin Care World, Gurgaon as early treatment can save you from unwanted distress.
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