Jordan News

Melasma is a common skin condition that causes brown to grayish-brown spots or patches to appear on the face, usually on the cheeks, chin, bridge of the nose, forehead and above the upper lip.

Melasma affects any race, but is most common on relatively dark skin (and less common on light or very dark skin), and is rare before puberty and more common in childbearing years (known as the mask of pregnancy).

Women are also affected 9 times more often than men, and the prevalence ranges between 1.5-33% and varies widely according to the population sample.

What are the reasons for its appearance?

There are several factors that contribute to the development of melasma in the patient, including:

1- Genetic factors.

2- Exposure to sunlight: Ultraviolet rays can stimulate melanocytes to produce excess melanin, sunscreens cannot block long-wavelength UV or visible radiation (320-700 nm), while UVB radiation (290-320 nm) cannot be blocked. nanometers).

3- Hormonal effects: Hormones play a role in the emergence of melasma, usually in pregnant women, levels of estrogen, progesterone and melanocyte-stimulating hormone increase during the last three months of pregnancy, which may constitute a predisposing factor for its occurrence.

As for women who have not given birth and suffer from melasma; Although they did not have increased levels of estrogen or melanocyte stimulating hormone, they were observed to have elevated levels of estrogen receptors inside the site of injury, and melasma was observed with the use of birth control pills that contain estrogen and progesterone, as well as one of the prostate cancer treatments.

Women may develop melasma after menopause if they receive progesterone treatment, while those who received estrogen treatment alone do not, and this indicates the primary role of progesterone in the emergence of melasma.

4- Thyroid diseases: There is a 4-fold increase in thyroid diseases in patients with melasma.

5- Some medicines and cosmetics may stimulate the occurrence of melasma.

The most important factor is exposure to sunlight; It occurs in places exposed to sunlight as an asymptomatic acquired hyperpigmentation with light or dark color and irregular borders.

How do we diagnose melasma?

The diagnosis is clinical, and examination using a “Wood” lamp and a dermatoscope, sometimes a skin biopsy may be taken, and the doctor may order tests for thyroid function in the case of melasma associated with pregnancy or taking birth control pills.

What is its differential diagnosis?

1- Post-inflammatory hyperpigmentation.

2- Drug-induced hyperpigmentation – drug-induced photosensitivity.

3- Black acanthosis nigricans.

4- Solar freckles.

5- Nevus of Ota and nevus of Ito.

6- Contact dermatitis pigmentosa.

7- Discoid lupus erythematosus.

And many more.