MELASMA by Sukamas Suwanwalaikorn, M.D.

MELASMA by Sukamas Suwanwalaikorn, M.D.

Melasma is a common acquired pigmentary disorder characterized by symmetrical hyperpigmented macules on the face. The word melasma originates from the Greek root “melas”, which means black, and refers to its brownish clinical presentation. Disease descriptions can be found in the medical literature extending as far as the reports of Hippocrates (470-360 BC). Melasma can affect both men and women but it is more common affects women of reproductive age especially those who tan well or have naturally brown skin (Fitzpatrick skin types III to VI).

Melasma typically presents as freckle-like spots or larger at brown to dark brown patches on cheeks, forehead, upper lip, nose and chin, usually in a symmetrical manner. Melasma causes psychosocial and emotional distress and has a negative impact on the quality of life of the affected individual due to it mainly affects the face.

What cause Melasma?

The cause of melasma is complex. Several factors have been involved in the etiology of melasma (Table1)

The Melasma pigmentation is due to overproduction of melanin by the mela- nocytes (pigmented cells). Melanin that is taken up by the keratinocytes is epider- mal melasma while melanin that deposited in the dermis is dermal melasma

Based on Wood's light (UVA) examination and histology of the skin, melasma can be classified into three types in accordance with depth of melanin pigment (Table. 2)