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What is melasma, what are the risk factors, and what can you do to manage this skin condition?

Melasma, a hyperpigmentation disorder that most commonly affects women, isn't dangerous — it neither causes pain or discomfort nor develops into skin cancer. This doesn't mean that melasma doesn't come with far-reaching consequences, however. When you're stuck with a permanent "mask" on your face, your self-confidence can start to crumble. What is melasma, what are the risk factors for developing it, and what can you do to treat it?

What Is Melasma?

Melasma is a pigmentation disorder in which darker patches of skin develop, most frequently on the facial skin and usually in a "mask-type" pattern. Typically appearing symmetrically on both sides of the face, melasma tends to affect the cheeks, upper lip, nose, chin and forehead, though it can also be limited to a smaller area. In some cases, melasma strikes the neck and forearms as well. These patches of darker skin aren't raised and do not cause any physical discomfort. 

When it appears in pregnancy, melasma is called chloasma, the notorious pregnancy mask some women develop while they are expecting a baby. The skin condition can affect people of all ethnic backgrounds, but 90 percent of those with melasma are women. 

While melasma doesn't cause any physical discomfort, the condition can lead to a great deal of emotional stress, and can reduce the quality of life of an affected person enormously. 

What Causes Melasma?

The cause of melasma is still unclear at present. Previously thought to be exclusively hormonal in nature, other factors are now being examined as well.

Hormones, we know, can indeed trigger melasma. This is seen not only in the "pregnancy mask", a pregnancy-induced form of the pigment disorder that affects between 10 and 15 percent of expectant mothers, but also in women who develop melasma while taking the birth control pill. Between 10 and 25 percent of pill users will develop melasma! Around 30 percent of people who suffer from Graves Disease, a form of hyperthyroidism, also end up with melasma. Hormones thought to be involved with the development of melasma include estrogen, progesterone, and α-MSH.

In recent years, it has become clear that melasma mainly strikes people in areas that get a lot of sun, and that sun exposure plays a large role in the development of the disorder in both men and women. This is an important finding, as excessive exposure to sunlight can be prevented — and proper sunscreen use may help some people avoid melasma altogether. Despite its association with sun exposure, melasma is not cancerous and doesn't turn into cancer down the road, either.

Finally, researchers have noted that melasma commonly strikes the same areas of the face as vascular disorders such as rosacea. There is, therefore, also a possibility that melasma is a vascular condition. 

If you suspect that you have melasma, a doctor can typically diagnose it on sight alone. In some cases, however, a skin biopsy will be carried out to confirm the diagnosis.

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