Melasma as it a common skin problem due to long duration of sun expose.. read more about it

1. A H M E D S A M I A L WE S A I B I E
MELASMA

2. OBJECTIVES
• General definition
• Etiology
• Signs and Symptoms
• Diagnosis
• Treatment and Management

3. WHAT IS MELASMA?

4. MELASMA (CHLOASMA)
• Melasma is a focal hyperpigmentation result from
neoplastic process.
• Usually due to Sun exposer.

5. PATHOPHYSIOLOGY

6. PATHOPHYSIOLOGY
• Melasma risk increases with increasing sun
exposure, the mechanism probably involves
overproduction of melanin by hyperfunctional
melanocytes.
• Other than sun exposure, aggravating factors
include
• Autoimmune thyroid disorders
• Photosensitizing drugs

7. PATHOPHYSIOLOGY
• Sun exposure: Ultraviolet (UV) light from the sun stimulates
the melanocytes. In fact, just a small amount of sun
exposure can make melasma return after fading. Sun
exposure is why melasma often is worse in summer. It also is
the main reason why many people with melasma get it
again and again.
• A change in hormones: Pregnant women often get
melasma. When melasma appears in pregnant women, it is
called chloasma, or the mask of pregnancy. Birth control
pills and hormone replacement medicine also can trigger
melasma.
• Cosmetics: Skin care products that irritate the skin may
worsen melasma.

8. MELASMA PRESENTATION
• Melasma consists of dark brown or (It causes
brown to gray-brown patches), sharply
marginated, roughly symmetric patches of
hyperpigmentation on the face
• (usually on the forehead, temples, cheeks,
upper lip, or nose).
• Some people get patches on their forearms or
neck. This is less common.

10. MELASMA RISK FACTORS
It occurs primarily in
• Pregnant women
• Women taking oral contraceptives.
• Dark-skinned men.

11. RISK FACTORS
• Melasma appears on women’s skin much more
often than men’s skin. Just 10% of people who get
melasma are men.
• People who have a blood relative who had
melasma also are much more likely to get
melasma.
• In women, melasma fades slowly and incompletely
after childbirth or cessation of hormone use.
• In men, melasma rarely fades.

12. DIAGNOSIS
• Dermatologists can diagnose most patients by
looking at their skin. By a device called a Wood’s
light.
• To rule out another skin condition may need to
remove a small bit of skin. This procedure is called a
biopsy

13. TREATMENT
• Melasma can fade on its own.
• If the melasma does not go away or a woman
wants to keep taking birth control pills, melasma
treatments are available.
• These include:

14. HYDROQUINONE:
• This medicine is a common first treatment for
melasma.
• It is applied to the skin and works by lightening
the skin. It’s came as a cream, lotion, gel, or
liquid.

15. TRETINOIN AND CORTICOSTEROIDS:
• To enhance skin lightening, dermatologist
may prescribe a second medicine.
• This medicine may be tretinoin or a
corticosteroid.
• Sometimes a medicine contains 3 medicines
(hydroquinone, tretinoin, and a
corticosteroid) in 1 cream. This is often
called a triple cream.

17. OTHER TOPICAL (APPLIED TO THE
SKIN) MEDICINES:
• Dermatologist may prescribe azelaic acid or
kojic acid to help lighten melasma.

18. SIDE-EFFECT
• Skin irritation.
• Darkening of the skin.
• Other problems.

19. OUTCOME
• Under a dermatologist’s care, many people with
melasma have a good outcome.
• Patient can help prevent melasma from returning
by wearing sunscreen and a wide-brimmed hat
every day.

20. MANAGING
Patient should:
• Wear sunscreen daily
• Wear a wide-brimmed hat outside
• Choose gentle skin care products
• Avoid waxing

21. REFERENCE
• Merck Manual professional Version.
• American Academy of Dermatology.

22. THANK YOU