Dr. Anurag Dhawan

A common skin condition, which causes the discoloration of your skin in patches across the face, melasma is more of a social embarrassment and cause for distress rather than being a serious condition. Although it affects men as well, studies have shown that over 90 percent of patients are women. It is also known as the mask of pregnancy as many pregnant women develop this skin condition.

Causes of Melasma - Primary causes of melasma have been attributed to various hormonal changes within the body. Let's look at some of the factors that may cause this disorder:

1. Pregnancy: This is often attributed as the leading cause of melasma, the primary cause has often been attributed to hormonal changes that a woman may experience due to pregnancy.

2. Treatments that may change hormonal balance: Women on contraceptive pills or who have implants such as intrauterine devices may also develop this disorder. This is due to the balance of estrogen and progesterone being changed within the body.

3. Sun exposure: Continued sun exposure may also lead to melasma. This is due to the activation of melanocytes within the body which start producing more melanin.

4. Stress: Long periods of stress on the body can also trigger hormonal changes and cause melasma.

5. Thyroid problems: If someone suffers from Hypothyroidism or low levels of the thyroid hormone, it can trigger other hormonal changes and also cause this skin disorder. 
It has also been noticed that people with generally a darker skin tone tend to get melasma and it is less common in people with fairer skin.

Certain characteristics of Melasma - Melasma develops in certain patterns which can be easily diagnosed either as spots on the skin similar to freckles or brown patches of skin that grow bigger. Some of these patterns are:

1. Malar pattern: This grows on the nose and cheeks
2. Mandibular pattern: Starts growing around the jaw line
3. Brachial melasma: This grows on the upper arms and shoulders
4. Lateral cheek pattern: Grows on the cheek on both sides of the face
5. Centrofacial pattern: Nose, upper lips, forehead and cheeks

Treatment of Melasma
Most women who develop melasma during pregnancy report that it goes away after childbirth. However certain forms of melasma may appear in non-pregnant women due to hormonal changes. Treating the underlying hormonal changes usually resolves the problem. However certain other methods may be required to resolve the issues such as skin creams, chemical peels, dermabrasion and microdermabrasion. If you wish to discuss about any specific problem, you can consult a dermatologist.