Chloasma

Chloasma

Chloasma, also known as melasma, is a common skin condition characterized by dark, discolored patches on the skin. It is often referred to as the "mask of pregnancy" when it occurs in pregnant women. This condition is more prevalent in women than in men and is particularly common among individuals with darker skin tones.

Etiology

Chloasma is primarily caused by an increase in melanin production, the pigment responsible for skin color. Several factors can contribute to the development of chloasma, including:

• Hormonal changes: Pregnancy, birth control pills, and hormone replacement therapy can trigger chloasma due to fluctuations in estrogen and progesterone levels.
• Sun exposure: Ultraviolet (UV) light from the sun stimulates melanocytes, the cells that produce melanin, leading to increased pigmentation.
• Genetic predisposition: A family history of chloasma can increase the likelihood of developing the condition.

Clinical Presentation

Chloasma typically presents as irregular, hyperpigmented macules and patches on sun-exposed areas of the skin. Common sites include:

• The face, particularly the cheeks, forehead, nose, and upper lip
• The forearms and neck, especially in individuals with significant sun exposure

The pigmentation is usually symmetrical and can vary in color from light brown to dark brown.

Diagnosis

Diagnosis of chloasma is primarily clinical, based on the characteristic appearance of the skin lesions. A dermatologist may use a Wood's lamp to examine the skin under ultraviolet light, which can help differentiate epidermal from dermal pigmentation.

Management

Management of chloasma involves a combination of preventive measures and treatment options:

• Sun protection: Regular use of broad-spectrum sunscreen with a high SPF is crucial to prevent further pigmentation.
• Topical agents: Hydroquinone, tretinoin, and corticosteroids are commonly used to lighten the skin. Other agents like azelaic acid and kojic acid may also be effective.
• Procedural treatments: Chemical peels, laser therapy, and microdermabrasion can be considered for resistant cases, although they carry a risk of irritation and post-inflammatory hyperpigmentation.

Prognosis

Chloasma is a chronic condition that can persist for many years. While it may improve with treatment, complete resolution is not always possible. Recurrence is common, especially with continued sun exposure or hormonal changes.

See Also

• Hyperpigmentation
• Dermatology
• Skin care

References

• Bandyopadhyay, D. (2009). Topical treatment of melasma. Indian Journal of Dermatology, 54(4), 303–309.
• Grimes, P. E. (1995). Melasma. Etiologic and therapeutic considerations. Archives of Dermatology, 131(12), 1453–1457.