Melasma: the mask of pregnancy

WITH melasma, the sufferer gets blotchy, brown spots on the face, usually on the cheeks, the forehead and on the nose. It is far more common in females but men can get it as well.

It may appear when a woman gets pregnant, hence the name 'the mask of pregnancy'. But it can fade on its own after childbirth.

It can also be triggered by birth control pills and female hormones and I believe it may be triggered and maintained by the use of soy products as these contain oestrogens which will not do your melasma any good.

Melasma always becomes worse with sun exposure and I often tell women who come to me for treatment that their worst enemy is the sun. A day of sun exposure can undo weeks of treatment, so please stay out of the sun.

Also, use your sunblock frequently. Wear a hat if at all possible and put a tint on the windows of your car. Try to arrange your life so that you are out of the sun between the hours of 10:00 am and 4:00 pm.

This condition can cause severe psychological distress. It can affect the quality of a woman's life. It can affect her social life, her recreational life and her emotional well-being.

Melasma is often defined by the depth of the pigment in the skin. If it is confined to the topmost layer of the skin — the epidermis — it is called epidermal. If it is in the deeper dermis, it is called dermal.

When you visit the dermatologist with this condition he will often examine the skin with a Woods Light. This is a black light and if the majority of the pigment is in the epidermis, the spots appear worse. If the majority of the pigment is in the dermis, the spots appear better. This is a most important tool in the management of melasma as it helps the doctor to access the depth of the extra pigment in your face. In a lot of cases we get a mixed pattern with both epidermal and dermal melasma.

Melasma can also be classified by where it occurs on the face. If it is on the centre of the face it is called centrofacial; if it occurs on the cheeks it is called malar; and if it occurs on the jaws it is called mandibular.

Triggers include genetic factors; ultra violet light and visible light; the heat and some occupations like those where there's work in hot kitchens. Melasma also seems to be commoner in people of lighter complexions.source