14/12/2022
Melasma (Chloasma)
Definition: a benign disorder characterized by characterized by hyperpigmentation
of sun-exposed regions due to excess
melanin production and deposition that is associated with pregnancy and oral contraceptive use.
Epidemiology
Common in dark-skinned individuals
Incidence in ♀ > ♂
Etiology
Sunlight/ultraviolet (UV) radiation exposure
Hormonal factors:
Pregnancy (melasma is often called the “mask of pregnancy”)
Use of oral contraceptive pills (OCPs)
Hormone replacement therapy (HRT)
Photosensitizing medications
Genetic predisposition
Strong association with thyroid disorders
Neoplastic diseases that produce hormones
Pathophysiology: Hyperactive
melanocytes deposit excess melanin in the epidermis and dermis of the skin.
Clinical features
Hyperpigmented lesions on the face
Exacerbated by exposure to sunlight (UV radiation)
Diagnosis: clinical diagnosis
Treatment
1. Sunscreen
2. Consider discontinuation of or alternatives to HRT and OCPs.
3. Patients should be screened for thyroid disease.
4. Topical depigmenting agents (e.g., hydroquinone)
