Melasma (Chloasma) - Medtick

Melasma (Chloasma)

What is it?

A common skin condition of adults in which light to dark brown or greyish pigmentation develops.

  • A condition of hyperpigmentation, typically symmetrical (both sides of body) and often on the face.
  • People with darker skin are generally more likely to have it.
  • The condition is benign (non- cancerous) and may resolve on its own but may be concerning to some patients due to its appearance.

There are three types:

  • Centrofacial –  involves the cheeks, chin, forehead, nose, and upper lip.
  • Malar – involves only the cheeks and nose.
  • Mandibular affects the ramus of the mandible (the part of lower jaw below the ear).

Diagnosis Tests

  • Excess melanin in patients with melasma can be visually localized to the epidermis or the dermis using a Wood lamp with a wavelength of 340-400 nm.

Cause

  • Exposure to sunlight (persons with light-brown skin types from regions of the world with intense sun exposure are much more prone to develop melasma and patients with darker Fitzpatrick skin types (FSTs) IV-VI are more likely to experience melasma than are those with fairer FST types II and III)
  • Air pollution (Polycyclic aromatic hydrocarbons and airborne particulate matter are believed to enter the skin through nanoparticles to produce reactive oxygen species that cause skin hyperpigmentation)
  • Swimming in sunlight
  • Hormonal changes
  • Family history
  • Pregnancy
  • Cosmetics:
    • Musk
    • 6-methylcoumarin

Medication

  • Hormonal:
    • Hormone replacement therapy (HRT)
    • Oral contraceptives
    • When exposed to sunlight , these medication make one more sensitive to the sun (photosensitizing).
  • Antibiotics:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Dermatitis herpetiformis (rash associated with celiac disease and eczema complications) medication: Dapsone
  • Retinoids  (Acne) medication
  • Hypoglycaemics (diabetes) Medication: Sulfonylureas (i.e. glipizide, glyburide)
  • Neuroleptics (anticonvulsants- used in epilepsy, sleeping medication and pain relief) medication
  • Phenothiazines (i.e. chlorpromazine, fluphenazine)
  • Thioxanthenes (i.e. chlorprothixene)
  • Heart, blood pressure and diuretic medication:
    • Amiodarone
    • Diltiazem
    • Quinidine
    • Enalapril
    • Furosemide
    • Bumetanide
    • Hydrochlorothiazide
  • Cramp and/or anti-malarial medication:
    • Quinine
  • Arthritis medication:
    • Hydroxychloroquine
  • Psoriasis and severe skin condition medication:
    • 5-Fluorouracil (oral and topical)
    • Coal tar
  • Common Photosensitising Topical Agents – sunscreens:
    • Benzophenones
    • Para-aminobenzoic acid (PABA)
    • Cinnamates
    • Salicylates

Symptoms

  • Darker-than-normal skin (tan to brown skin) in darker skin (blue to black skin) affecting the cheeks, forehead, upper lip, nose and chin?
  • Darker-than-normal skin (tan to brown skin) in darker skin (blue to black skin) affecting the part of lower jaw below the ear?
  • Both sides of body or face?
  • Live in sunny climates?

Complications /Information to beware of/General tips:

General tips

  • Sun protection
  • Many cosmetics can trigger this condition (treatment should be considered by a skin specialist).

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

Detailed Information

Please copy and paste any key words from the title: Melasma (Chloasma) in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).