Melasma (Chloasma, Pregnancy Mask) in Caucasians: Epidemiology and treatment (For Professionals)

Epidemiology

Melasma (chloasma, pregnancy mask) is more frequent in Caucasian individuals with the following genetic factors:

• In Germans, Poles and Russians
• In individuals of Jewish descent (location is typically on the the face)
• If we take into account skin phototypes (Fitzpatrick):

1. types I and II phototypes tend to have melasma before pregnancy and in young women
2. (types V and VI tend to have melasma at a later age (after pregnancy) and even post-menopausal)

It can have a dermal and/or epidermal location. Wood’s lamp is useful to determine the depth  as well as to differentiate with other pigmentary disorders such as post-inflammatory hyperpigmentation

Treatment of Melasma

• Prevention
• Choice of contraceptives
• Sunscreen (against visible light and not only UVs)

Treatment depends on the depth of pigmentation:

• Superficial (epidermal) pigmentaton:

1. bleaching agents (Hydroquinone, arbutin, azelaic acid, kojic, tretinoin, lipoic acid…)
2. A word on retinoids (tretinoin): they can be used to treat Melasma, PIH (post inflammatory hyperpigmentation), Lentigenes….they eliminate pigmentation but do not depigment normal skin.

• Deep (Dermal) pigmentation

1. Chemical peels
2. Dermabrasion
3. Lasers

To learn more about a safe and effective depigmenting cream, click here.

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland

Source of Information: 2012 (09) – Placek W. 21st Annual Congress of the EADV (European Academy of Dermatology and Venerology) – Prague (Praha), Czech Republic (česká republika)