A condition in which pigmentation of the cheeks of the face darkens into tan or brown patches. This condition occurs in half of all women during pregnancy. It is symmetrical patches of brown pigment on the face. Most often seen in females and can be exacerbated by estrogen and sunlight.

Skin

Young women with brownish Skin tones are at greatest risk. Is often associated with the female hormones estrogen and progesterone. In a pregnant women, women who are taking oral contraceptives ("the pill"), and women taking hormone replacement therapy during menopause. Sun exposure is also a strong risk factor for melasma. It is particularly common in tropical climates.

Melasma doesn't cause any other symptoms besides Skin discolouration but may be of great cosmetic concern.

A uniform brown colour is usually seen over the cheeks, forehead, Nose, or upper Lip. It is most often symmetrical (matching on both sides of the face).

Your physician can usually diagnose melasma based upon the appearance of your Skin. A closer examination using a Wood's lamp may help guide your treatment. Wood's lamp is a test that is performed in a dark room, shining ultraviolet light on the area of interest. You will be seated and the lights will be turned off. Your physician will turn on the Wood's lamp and hold it 4 - 5 inches from the area being studied. Your physician will then look at your Skin for any colour changes. Take care not to look directly into the light. No special preparation is needed. If you are treating the area in question with any topical medications, you may wish to skip an application before visiting the doctor. This test is performed to detect several conditions, including:

Bacterial infections Fungal infections Porphyria Pigmentary alterations

Normal Values: Normally your Skin will not fluoresce, or shine, under the ultraviolet light. Using the light, your doctor may be able to confirm a diagnosis of fungal infection or bacterial infection. Your doctor is also be able to gain insight into the cause of light- or dark-coloured spots on your Skin. There are no risks, but avoid looking directly into the ultraviolet light, as you avoid looking into the sun.

Daily sunscreen use not only helps prevent melasma but is crucial in the prevention of Skin cancer and wrinkles.

A combination of tretinoin cream and a bleaching cream containing hydroquinone may be helpful in fading some types of melasma. Occasionally, your physician may add chemical peels or topical steroid creams as well. In severe cases, laser treatments can be used to remove the dark pigment.

Melasma often fades over several months after stopping oral contraceptives or hormone replacement therapy or after delivering a child. It may return with additional pregnancies or use of these medications.