Melasma is an acquired hyperpigmentation in areas exposed to the sun, which can be caused by pregnancy or the use of contraceptives. Melasma appears as a hyperpigmented spot with a symmetrical distribution that can be contiguous or reticulated. Areas that are overexposed to the sun, including the cheeks, back of the lips, chin, and forehead, are the most common places. However, melasma can sometimes occur other places exposed to the sun also occur.

Causes of facial spots:

Melasma is multifactorial and not completely clear. There appears to be a direct relationship with women’s hormonal activity, as melasma occurs more often in women than in men and is usually developed or worsened during pregnancy and with the use of oral contraceptives.

In fact, half of melasma cases first appear during pregnancy. Whether or not hormone levels play a role in the development of melasma in men is still unclear. Other factors involved in the pathogenesis of melasma are drugs that sensitize the skin to light, mild ovarian disorders, and some cosmetics.

There is clearly a role for genetic predisposition as well, as a family history of melasma is known to be a significant risk factor for developing it. About 55 to 64 percent of Patients with melasma have a family history of this disease. The most important factor in causing melasma is exposure to sunlight. Ultraviolet light causes the production of reactive oxygen species in the skin, which subsequently causes melanogenesis.

Removing a deep skin spot may take longer than a superficial spot because no effective treatment can remove the dermis pigment. However, treatment should not be stopped simply because of the predominance of skin pigmentation. If the melanogenesis of the epidermis can be inhibited for a long time, the deep pigments of the skin will not be replenished and slowly It will be fixed.

Teaching the patient:

Extreme avoidance of the sun is necessary to remove and prevent the recurrence of blemishes. Melasma patients should use anti-blemish creams only on dark areas. Treatment by avoiding strong sun and topical anti-blemish creams can take months. Patients should wait for a slow but gradual lightening of the stain.

Use anti-blemish creams that are medically approved, as creams with high concentrations of lightening agents can lead to paradoxical hyperpigmentation if overused.

Treatment:

Melasma is very difficult to treat. Melasma pigmentation develops gradually and the resolution is gradual. Resistant cases or relapses of melasma often occur, especially if sunlight is not avoided. All wavelengths of sunlight, including the visible spectrum, are capable of causing melasma. The most commonly accepted treatment is extreme sun avoidance.

It is often combined with anti-spot topical cream and anti-spot mesotherapy and PRP. One third of patients may not respond to treatment.