Preventing and Treating melasma (chloasma, pregnancy mask): Basics of Sunprotection, Practical Advice and Quick Fixes

• Melasma (chloasma, pregnancy mask) is notoriously difficult to treat and relapses are the norm in those responding to treatment
• Sunprotection must be against visible light and not only UV light.
• We cannot stress the importance of using sunprotection by:

1. adopting sun avoiding behaviour
2. avoid going in the sun between 10 am and 4pm (11am and 5pm if on summer time (daylight saving))
3. wear a wide-brimmed hat
4. carry an umbrella
5. seek the shade
6. avoid light refecting surfaces such as sand and snow

• by wearing sunscreen

1. of at least 30 SPF (Sun Protection Factor) in temperate climates or hugher phototypes (IV and above)
2. of at least 50 SPF in sunny climates, when up in the mountains or in lower phototypes (III and below)

Physical sunscreens containings metallic particles such as titanium dioxide and zinc oxide are preferred ovec chemical sunscreens because they have the ability to reflect all light and therefore have a broader spectrum of action.

• Quick fixes such as cryotherapy, chemical peels and lasers (as a first line treatment) should be avoided: not only the results are unpredictable, but side-effects such as post-inflammatory hyperpigmentation (PIH) and scarring can occur.
• Mainstay of treatment remains topical with the use of creams.

Bibliography: Chloasma–the mask of pregnancy. Bolanca I, Bolanca Z, Kuna K, Vuković A, Tuckar N, Herman R, Grubisić G.Coll Antropol. 2008 Oct;32 Suppl 2:139-41. Review.