Melasma, or the mask of pregnancy or cholasma, is a skin hyper-pigmentation that has been linked to an accumulation of female sexual hormones, such as estrogen and progesterone. Melasma may occur during pregnancy or during a therapy with sexual hormones or contraceptive pills. Melasma may be diagnosed by judging the appearance of the dark patches and by performing a test with Wood’s lamp.

Melasma Appearance

Melasma manifests through darker patches that are more frequent on the cheeks, nose and upper forehead. The dark brownish patches will be symmetric, and these may be confluent or punctuated.

Melasma may appear both in men and women, but women develop this skin condition more frequently. Melasma will occur after exposure to sun. If you haven’t been exposed to sun lately, the dark patches are probably not melasma. The melasma will also be less visible during winter; the dark patches may lighten during winter.

Melasma Symptoms

In addition to the appearance of the brown patches, you won’t have any other symptoms. The skin will not be itchy or flaky.

Diagnosing Melasma

Melasma may be diagnosed by a dermatologist; the dermatologist will take a look at the dark patches and may also ask you a few questions about medications or birth control pills that you may take.

To differentiate between melasma and other skin conditions that may have a similar appearance, the dermatologist will perform a lamp test. Wood’s lamp will be used; the lamp emits a fluorescent light with variable wavelength (between 340 and 400 nm). The lamp will show if the hyperpigmented areas are caused by an excess of melanin, and if the patches are at the superficial level of the skin. Melasma is caused by an excess of melanin.

Melasma Causes

Melasma is common in pregnant women, as there is a high concentration of estrogen and progesterone hormones in the system. Women that take oral contraceptives or use a contraceptive patch may also develop melasma. Menopausal women under hormone treatment may also experience dark patches on the skin. The production of melanin in excess is caused by the sexual hormones, but its triggered by the exposure to sun.

Melasma Treatment

Melasma may be removed through laser therapy, such as Fraxel or Smartxide Dot Therapy, but there are also less complicated ways to lighten melasma.

  • Creams that contain tretinoin and hydroquinone have been proven highly effective in reducing the appearance of melasma.
  • Chemical peels may also be applied, along with a steroid cream treatment.
  • You may also opt for a few at home remedies, such as lemon or parsley juice, sour cream, castor oil or liquid vitamin E.
  • Avoid using bleaching agents and skin lighteners that may have a damaging effect on the skin.

Melasma Prevention

If you are pregnant or take hormones or contraceptive pills, you should protect yourself from the sun rays. Use a sun block with a SPF of 15 or over at all times. Sun block and reduced sun exposure may also be helpful in preventing wrinkles, age spots and skin cancer.