Melasma: Symptoms and Causes

What is that melasma? Chloasma or melasma is a skin disorder in the form of patches with the formation of the dye bark excessively, colored black and brown, are generally symmetrical, uneven, such as discoloration of the skin, often found on the face, the cheeks, forehead, chin, upper lip , and can extend up to the neck.

Generally occurs in pregnant women or users of oral contraceptives (eg, birth control pills). Melasma is excessive melanin formation caused by exposure to ultraviolet and sunlight.

The cause of melasma, Trends genetics, hormonal influences, and ultraviolet radiation is the most important cause of melasma. More than 30% had a family history of melasma patients who also suffer from melasma. Oral contraceptive pills that contain estrogen-progesterone therapy for prostate cancer can also cause melasma. Medical therapy of allergies and certain cosmetics reported cause melasma, though rarely.
Melasma is rare before the age of puberty. Commonly experienced by adults aged 30-44 years (productive age) and is more common in women. In Indonesia, a comparison of this case to the women and men is 24: 1.

Clinical symptoms of melasma disease begins with patches of black and brown on the cheek, and then extended to the entire face. Skin disorders melasma, hyperpigmentation Plaques with no firm boundaries. Injuries and disorders are usually symmetrical, especially when on the cheek, spread to resemble a mask.
Location disease melasma may occur on the entire face, but mostly on the cheeks, forehead, chin, under the nose, below the lower jaw.

Melasma examination, to determine the type of melasma, Wood lamp examination (with a wavelength of 340-400 nm). There is thickening of the outermost layer of skin; the formation of excessive keratin, but relatively mild. In the basal cells and suprabasal found to deposit melanin. Sometimes melanin is found in all layers of keratinocytes in the epidermis. Melasma Area and Severity Index (MASI) commonly used doctors to assess the condition of patients with melasma. Consider the results of tests to evaluate thyroid function. Not required laboratory tests.

Handling melasma, medications antipigmentasi (depigmenting agents), adjusted for the skin condition of each patient. Hydrogen peroxide and topical corticosteroids. Vitamin C high dose. Vitamin C is thought to inhibit the oxidation dopakuinon. Glutathione. Glutathione is a tripeptide which has a -SH group, may join the cupric ions (Cu) and the enzyme tyrosinase that disrupted melanin formation. The use of bleach (bleaching), which is able to inhibit the activity of the enzyme tyrosinase in the melanocytes, resulting in the formation of melanin is reduced. Retinoids, serves to regulate cell growth and proliferation. For example: topical tretinoin. The use of retinoic acid would affect the pigments in the keratinocytes, also interfere transferpigmen. The use of tretinoin efektifsebagai single therapy. Improvements achieved in a minimum of 6 months.
Laser surgery, using a Q-switched ruby ​​laser and argon laser. Chemical exfoliation, performed by a dermatologist or beautician. Antibiotics, Mass lnya: azelaic acid cream (20%).

Topical therapy approved by the US Food and Drug Administration (FDA) for the treatment of melasma is Triple Combination Cream, containing hydroquinone (4%), tretinoin (0.05%), and fluocinolone acetonide (0.01%). Triple Combination cream is safe and effective when used alternately or continuously for 24 weeks.
Combination treatment with the triple combination cream followed by a laser (1064-nm Q-switched Nd: YAG) proved to be effective, not followed by serious side effects. Topical therapy should be initiated at least eight weeks prior to laser therapy to achieve optimal results.
In topical therapy with a concentration of 4% or less, only a few patients experienced severe side effects.
Generally, the longer the treatment of melasma about 4-6 weeks. Although many treatment products in the form of creams, ointments, capsules, extracts, and others that aims to overcome melasma, be sure to use it with a doctor's supervision. This is to avoid complications or irritations that actually worsen the situation. Better to come immediately to the doctor or dermatologist to get treatment and good handling and measurable.

Melasma can be prevented by: Avoiding the sun, wearing a hat, umbrella, sunscreen and Stopping the use of contraceptives.
The hormone estrogen, progesterone, and MSH (melanocyte-stimulating hormone) can stimulate the occurrence of melasma. Ultraviolet light can stimulate pigment formation process. Melanin (melanogenesis).

Systemic drugs such as chloroquine, chlorpromazine, cytostatic, and minocycline can stimulate melanogenesis. Melasma can occur in men and women who are not pregnant and not using the contraceptive pill.

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