What Is Melasma?

Melasma is a commonly found disorder of the skin in which you develop a patchy, brownish pigmentation on those parts of your body which are exposed to the sun. Though it can be found on all the sun exposed parts, you’ll commonly find Melasma as symmetric patches on your cheeks, upper lip, chin and the forehead. When you develop Melasma during pregnancy, then it may also be referred to as "Chloasma".

Melasma generally results due to the excessive production of melanin by the pigment cells of your body known as "Melanocytes". This condition is more common in the tropical climates. Though it can be found in males, Melasma is basically a skin disorder of the females, especially in the reproductive age group of 20 to 50 years of age. It is rarely seen before the onset of puberty. Besides, exposure to sun, melasma has also been attributed to the hormonal changes taking place in your body, as in pregnancy or after taking hormones from an exogenous source, like birth control pills.

Over 90% of all Melasma cases have been diagnosed in women. Around 45 to 50 million women are affected from it world wide. It is more common in women who tan easily or have a naturally dark skin tone, like women of Hispanic, Asian and Middle Eastern origin.

Besides the symmetric brown patches on the face, Melasma hardly produces any other symptom. The diagnosis is usually based on clinical examination by your physician as well as examination under a "Wood’s lamp" (340 to 400nm wavelength). Very rarely, a skin biopsy may be required to differentiate the patches from the other causes of skin hyper pigmentation.

Melasma can be classified into four groups based on the site of appearance of the tan, the clinical features and the response to treatment. They are:

Epidermal Melasma: The excessive Melanin responsible for the patchy discoloration is mainly concentrated in the superficial layers of the skin. The rashes have a well defined border and appear dark brown. They are more evident under the black light of the Wood’s lamp and show a good response to treatment.

Dermal Melasma: In this type of Melasma, you can find a lot of "melanophages", cells that ingest Melanin, spread across the dermal layer of the skin. The rashes have borders which are not well defined and are light brown in color. They are difficult to be observed under the black light. The response to treatment is not very heartening.

Mixed Melasma: It includes the features of both epidermal and dermal types of Melasma. The patches are both light and dark brown in color and the Melasma responds only partially to the treatment.

An Unnamed Variety of Melasma: It is a rare kind of Melasma found in dark skinned individuals where you find a lot of Melanocytes in the layers of the skin.

The rashes found on the face in Melasma can also be divided into three types, depending on the place where they are more predominant. They are:

Centro facial Pattern: It is the most commonly found pattern of Melasma, wherein the patches can be found on the forehead, cheeks, upper lip, chin and the nose.

Malar Pattern: In this pattern, the patches are confined to the cheeks.

Mandibular Pattern: In this form, the patches of Melasma are concentrated around the region of the jaw.

Occasionally, Melasma may spread to the sides of your neck and may even involve the shoulders and upper arms. Rarely, a unique form of Melasma has been seen on the forearms of native American Indians receiving exogenous progesterone.

The treatment of Melasma is basically geared to protect you from tanning and involves the use of sun screens and creams for fading the hyper pigmentation.

So, Melasma is basically a skin condition, usually affecting women in the age group of 20 to 50 years, resulting in the hyper pigmentation of the face in a characteristic fashion. Exposure to sun, heredity and female hormones are the usual causative agents and the disease can be prevented by avoiding sun.