Friday, January 17

Melasma hyperpigmentation - Melasma causes and symptoms

Melasma signs, symptoms and causes
Melasma (aka chloasma or the mask of pregnancy) is hyperpigmentation of skin caused by the excess deposition of melanin pigments. Symptoms of melasma discolorations appear as irregular light brown to dark brown patches.
Exposure to sun causes the lesions to spread and darken.
Melasma is found to develop in women in their 20 to 50 years of age.
It is rarely seen in men and only 10% of the melasma cases are seen in men.
Pregnant women, those taking oral contraceptives or undergoing hormone replacement therapy (HRT) are likely candidates for developing melasma hyperpigmentation.
The facial hyperpigmentosis is a very disturbing cosmetic problem and causes considerable emotional and psychological impacts.

Melasma appears to be a familial condition as it is found to run in families. People with light brown, olive and yellow skin color have higher rate of melasma incidence. In the summer months the hyperpigmentation is found to intensify and spread and in the winter months the lesions lighten and fade.
Picture of melasma hyperpigmentation on the face
picture of melasma on face
Image by Elord | CC BY-SA 3.0
www.wikidoc.org

Signs and symptoms of melasma

The appearance of light brown lesions is the early symptom of this hyperpigmentation.
The older lesions may appear grayish brown in color.
The patches are irregularly shaped and have well-defined margins.
Another symptom is that the hyperpigmentation tend to darken on sun exposure.
The lesions usually appear on the face and develop on the forehead, cheeks, chin, upper lip and sides of the nose.
Another typical symptom is that the lesions are symmetrical, affecting both the sides of the face.

What causes melasma?

The exact cause of the development of melasma hyperpigmentation is complex and is not clear. Complex factors interrelated to genetic predisposition, female hormones (estrogen and progesterone) and UV radiation appear to cause the lesions. The endogenous factors which trigger the lesions include female hormones and genetic predisposition.

The exogenous factors which trigger this hyperpigmentation include sun exposure, hormonal medications, cosmetic preparations and post inflammatory hyperpigmentation. However in men hormonal factor is not relevant and the etiological factors appear to be sun-exposure, family history, use of cosmetic preparations and chronic inflammatory illness.

Apart from the excess production of , these etiological factors contribute an increase in the number of melanocytes (melanin producing cells). There may be proliferation and dilation of capillaries in the dermis. In chronic cases bluish-grayish-brown hyperpigmentation is due to the skin pigments slipping into the dermis.

Anomalies in the functioning of the pituitary gland may cause hyperpituitarism (hypersecretion of pituitary hormones). Hypersecretion of melanocyte–stimulating hormones (MSHs) by the pituitary gland is also believed to cause the hyperpigmentation.

Etiological causes

  • genetic predisposition
  • pregnancy
  • menopause
  • increased estrogen, progesterone secretion by the body
  • hormone replacement therapy (HRT)
  • ovarian disorders
  • hormonal imbalance can cause melasma
  • increase in melanocyte-stimulating hormone (MSH)
  • oral contraceptives
  • sun exposure and the use of sunbeds
  • cosmetics
  • perfumes
  • toiletries
  • phototoxic reactions
  • certain medications
These hyperpigmentation lesions can treated but their recurrence is always possible. Avoiding the triggering causes can help in controlling and resolving the melasma patches.


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Skin pigmentation on face.
Hyperpigmentation on face.
Hypopigmentation on face.
References:
1.Vaneeta M. Sheth, Amit G. Pandya. Melasma: A comprehensive update Part I & II. Journal of the American Academy of Dermatology Volume 65, Issue 4, October 2011. Picture source: http://www.wikidoc.org/index.php/File:Melasmablemish.jpg Picture author: Elord from Wikidocs | License: CC BY-SA 3.0

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