Melasma

• Hormonal changes

  Most often, melasma is associated with hormones, especially in women during pregnancy (known as the "mask of pregnancy" or chloasma), use of birth control pills, or hormone therapy.

• Sun exposure

  Sun exposure is one of the main triggers of melasma. UV rays stimulate melanin production, which can worsen existing hyperpigmentation.

• Genetic predisposition

  People with lighter skin who are genetically prone to hyperpigmentation have a higher risk of developing melasma.

• Medicines and chemicals

  Some medications or chemicals can cause changes in skin pigmentation, which can result in melasma. For example, some epilepsy medications and hormone treatments may be linked to this condition.

Symptoms of melasma

• Dark spots on the skin

  The main symptom of melasma is symmetrical dark patches or spots on the skin. The patches are usually brown, gray-brown, or even bluish, and can vary in size.

• Localization on the face

  The spots most often appear on the face, especially on the cheeks, forehead, nose, and upper lip (known as the "mask of pregnancy" or chloasma).
  
  In rare cases, melasma can affect other parts of the body, such as the neck, arms, or shoulders.

• Symmetry

  The spots are usually symmetrical, meaning they appear on both sides of the face, which is a characteristic sign of melasma.

• No other changes in skin texture

  Although melasma causes skin discoloration, the skin usually remains smooth and without signs of scarring or other damage. The patches are not associated with pain, itching, or irritation.

• Increase in spots with sun exposure

  The spots may become darker when the skin is exposed to sunny conditions, due to increased melanin production in response to UV rays.

• Sometimes discomfort with taking hormones

  In cases where melasma is associated with hormonal changes, such as pregnancy, taking birth control pills, or hormone therapy, spots may appear at certain times.

Aesthetic and functional consequences of melasma

• Changes in skin appearance

  The main aesthetic consequence of melasma is dark spots on the face, which can have a significant impact on a person's appearance. The spots are usually symmetrical and appear on areas such as the cheeks, forehead, nose and upper lip. This can cause uneven skin tone, which many people find aesthetically unappealing.

• Decreased self-confidence

  Due to the visible dark patches on their skin, people with melasma can feel insecure about their appearance. This can lead to decreased self-confidence, especially if the melasma is not well controlled or treatments have not yielded the expected results.

• Impact on social perception

  Although melasma is not a disease, the cosmetic problems can affect how a person is perceived in social situations. Some people may feel uncomfortable or embarrassed by the changes to their face, which can affect their interpersonal interactions.

• No significant functional consequences

  Melasma does not usually cause physical symptoms such as pain, itching, or irritation, so it is considered a cosmetic problem. People with melasma may not have any functional impairment associated with the condition.

• Sun protection required

  Although melasma itself does not affect skin function, its treatment requires increased sun protection. People with melasma must regularly protect themselves from UV radiation, as sun exposure can worsen the condition, causing the spots to darken. This factor may lead to changes in daily routines, as it is important to use sunscreen, even on cloudy days.

• Risk of scarring or new pigmentation

  If melasma is treated with aggressive treatments, such as chemical peels or laser treatments, there is a risk of scarring or new hyperpigmentation, especially if the skin is not protected from the sun after treatment.

Melasma treatment

• Sun protection

  A key element in the prevention and treatment of melasma is the use of high SPF creams, as sun exposure can worsen the condition. Daily use of sunscreen with a high SPF (at least 30) is mandatory.

• Topical treatments

  A dermatologist may recommend creams that contain ingredients such as hydroquinone, tretinoin, azelaic acid, or vitamin C, which can lighten spots.

• Chemical peels

  Chemical peels can help remove the top layers of skin and reduce pigmentation, although caution should be used as they can cause irritation.

• Laser treatments

  Some lasers can effectively reduce melasma, but the treatments can be expensive and sometimes cause side effects such as scarring or new hyperpigmentation.