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Melasma is a common hyperpigmentation disorder characterised by dark grey-brown patches on the skin, especially on the face and sun-exposed areas. The condition is more prevalent in women than in men. When melasma occurs during pregnancy, it is known as chloasma.
In melasma, the skin becomes darker than the surrounding areas. It mainly occurs on cheeks and forehead on both the sides and are approximately similar in pattern. Though the dark patches aren't harmful, they can cause embarrassment and low confidence in people. Let's know more about this skin condition.
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Causes Of Melasma
Melanin is a natural skin pigment that gives skin its colour. In dark complexion individuals, the amount of melanin is large while in lighter complexions, the amount is low. Skin cells named melanocytes produce melanin. Though these cells are equal in every person, the amount of melanin secreted gives complexions to people. 
Melasma occurs when melanocytes dysfunction. The exact cause is still unknown but several triggering factors may cause dark patches on the skin. The factors are:
- Sunlight: The UV rays of the sun sometimes stimulate melanocytes cells and make them produce more melanin causing melasma.
- Pregnancy: Melasma is also known as ‘mask of pregnancy' as it tends to appear in around 70 per cent of women during their second or third trimesters. During pregnancy, hormonal balance disrupts, including the imbalance of estrogen and progesterone that results in increased secretion of melanin. 
- Skin complexion: People whose skin tone ranges from medium to medium-dark are more susceptible to the condition. This is because they easily get tanned in the sunlight due to the excess production of melanin. In people with very light or very dark skin tone, the condition is uncommon.
- Medications: Birth control pills, anti-seizure medications and hormone replacement therapy sometimes make the skin very sensitive. In this case, sun exposure becomes a high-risk factor and causes melasma.
- Genetics: Melasma is not hereditary but it is mostly seen in people who have relatives with the same problems. If melasma is in the family, even a small triggering factor can cause the disorder.
- Thyroid problems: Thyroid gland in the body produces hormones that regulate most of the body functions. When thyroid gland dysfunctions, it affects the hormones which in turn, affects the melanin production and cause melasma. 
Symptoms Of Melasma
- Darker skin in certain areas compared to the normal ones.
- Discoloured patches on the forehead, upper lips, both the cheeks and bridge of the nose. 
- Dark patches on the arms and neck (rare)
- Uneven and blotchy skin tone.
- Discoloured spots or irregular borders on the skin.
- Light brown or black discolouration.
- Matching and symmetrical patches on both cheeks
Note: Melasma does not cause any pain, itching or burning sensation.
Risk Factors Of Melasma
- Birth control pills 
- Laser treatments
Complications Of Melasma
Melasma is not a chronic condition but it can get permanent if not treated properly. Sometimes, it may go away on its own but without treatment, the condition stays for longer causing darker skin of multiple layers. This causes annoyance embarrassment to people.
Diagnosis Of Melasma
- Wood's lamp examination: The lamp emits long-wave UV light that helps in getting a clear view of patterns, sun damage and layers of melasma which cannot be viewed with the naked eye. It also helps rule out bacterial or fungal infections. 
- Skin biopsy: In this method, a small skin part is taken and viewed. The test helps to confirm melasma. However, it is not carried out often. The process is done when the medical expert doubts that dark patches can be due to other reasons such as Addison's disease, maturational dyschromia, lupus, inflammatory acne or freckles.
Treatment Of Melasma
When melasma occurs during pregnancy, it goes away on its own once the pregnancy ends. The condition does not cause any health problem, so it can only be treated cosmetically, depending on one's choice. Some treatment methods include:
- Topical steroids: To lighten the affected areas. 
- Chemical peels: In this method, the top layer of the dark skin is removed chemically to get the lighter tone. The process requires follow-ups and certain skin practices.
- OTC products: Suggested by experts when melasma is limited to a small area and less dark. These products are also suggested to maintain the skin after proper treatment.
- Laser treatments: A cosmetic application in which laser light is used to treat underlying skin conditions.
- Microdermabrasion: It is a cosmetic procedure in which the skin's outermost layer is exfoliated. It is a painless procedure that makes the skin softer and glowing. 
How To Prevent Melasma
1. Cover your sun-exposed areas such as cheeks, forehead and lips every time you walk out in the sun.
2. Apply sunscreen with SPF 30 or more every day..
3. Wearing a hat for an outdoor activity is also a good option.
4. Avoid sunbath during pregnancy.
5. If you are on certain skin treatment, follow it well for the best result.
6. Avoid scrubbing as it may irritate the skin.
7. Wear make ups right for you skin (optional)
1. Will melasma go away?
If taken proper care, melasma can go on its own. However, in most of cases, a good treatment removes the dark patches. Just be patient and take care of your skin daily.
2. What hormone causes melasma?
Estrogen, the primary female sex hormone is responsible for melasma. This is the reason why melasma is higher in female than male.Progesterone is also somewhat responsible for the condition.
3. What makes melasma worse?
Sunlight makes melasma worse. High exposure to UV rays stimulates the excess production of melanin. However, when sun exposure is reduced, the skin may get back to normal.
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