Melasma, spots on the face
Melasma is a skin state that manifests in dark hyperpigmented spots, commonly on the face. Usually they can be seen on the cheeks, forehead, above the lips, nose ridge. Melasma is common in women while only 10% of cases appear in men.
The exact cause of melasma is unknown. Changes in hormonal status, and also genetic predispositions, can be a trigger to the disease. Melasma is often joined with pregnancy or taking of contraceptive pills. Replacement hormonal therapy in climax doesn’t lead to the occurrence of pigmentation. Ultraviolet radiation and strong reflector light can provoke pigment synthesizing. Any irritation of the skin can cause pigment increase in persons with darker skin. Melasma, no matter what, is not a sign of any disorder in the organism, or a dysfunction in one of the organs.
Diagnosis is given by a simple skin examination. A biopsy is very rarely needed to prove a disease. Creams with protective UV factor are mandatory in treating these pigmentations. They must contain protection from UVA and UVB rays, and the protections factor mustn’t be less then 30. All the substances that irritate the skin can only worsen the state and application should immediately be stopped. There is a whole spectrum of creams with bleaching effect in the market, and the ones most commonly used are: hydroquinone, azelaic acid, retinoids and rucinol. These substances decrease the activity of the cells that produce pigment. Therapy must be at least three months and can be efficient only in very mild cases of melasmas. Chemical peels, microdermoabrasion and laser abrasion are used in treating serious cases of melasma. Chemical peels are a successful method, because they can’t create a reactive pigmentation. Equally successful are the laser treatments, but there is a danger of irritation and pigmentation worsening.
These procedures must be performed by a dermatologist due to possible side effects of the treatment. Avoiding the UV rays exposure and irritants, with regular treatments and adequate skin care can lead to very good results.
Spec. Dr. Svetlana Djurisic, dermatologist
Dermatological clinic DERMATIM, Belgrade - Serbia