Melasma is a patchy discoloration, or hyperpigmentation of the skin that can form on the face, forearms and neck. According to the American Osteopathic College of Dermatology, most cases of melasma occur in women of reproductive age who have darker skin tones; however, a small number of men--some 10 percent--also acquire the condition.
Pregnancy
The cause of melasma is primarily unknown; however, family history seems to be a predisposing factor. Hormone fluctuations may also cause hyperpigmentation. During pregnancy, overproduction of melanin, the substance that gives the skin its color, may occur. Known as cholasma or the mask of pregnancy, this type of melasma can resolve on its own after childbirth.
Other Causes
Birth control pills also increase incidence of melasma. Though the direct connection is not yet understood, the hormones estrogen and progesterone may stimulate excessive production of melanin. For men, certain medications used in the treatment of prostate cancer correlate with an increased incidence of melasma. Sun exposure is the most common culprit. Ultraviolet, or UV, rays stimulate melanocytes, the cells that produce skin pigmentation or color.
Self-Treatment
Though harmless, the stigma of a severe melasma case can affect quality of life. Because of this, people with melasma may opt to treat the condition themselves. Cholasma may resolve naturally, once normal hormone levels return following childbirth. Women who are on birth control may decide to quit taking it and switch to another form of birth control to control exposure to estrogen and progesterone.
Over the counter creams are available. A whitening agent called hydroquinone should be the active ingredient. Always use as directed.
Other Treatments
More aggressive treatment options are available, but you should know resolution of melasma takes time and may involve more than one course of therapy. Whitening creams with a higher percentage of hydroquinone are available by prescription. Other options include microdermabrasion, chemical peel or laser therapy. All three methods remove layers of skin and can be performed by a licensed dermatologist or plastic surgeon.
As with any therapy, results vary. Talk with your physician before making any decisions to decide on the best approach for you.
Other Considerations
The use of sunscreen is probably the most effective measure that can be taken to prevent melasma. The American Academy of Dermatology recommends an SPF of at least 30. When choosing a sunscreen, be sure it provides UVA and UVB protection. UV, or ultraviolet rays, contribute to sunburns and skin cancer. Protect yourself even on cloudy days and even in the winter.
