Melasma which is also called the mask of pregnancy or cholasma is both sun-exposed and
hormone related and usually appears as a tan or dark discoloration on the face of pregnant women
or women taking birth control or hormone replacement therapy. Current thought is that the female
hormones estrogen and progesterone stimulate the skin melanocytes to produce more pigment
called melanin.
In addition,melasma seems to be more prevalent in women living in areas with intense sun
exposure. Unusual causes of melasma include allergic reactions to medications and cosmetics.
The good news about melasma is that the discoloration usually diasppears on its own several
months after giving birth or stopping oral contraceptives or hormone replacement therapy. The bad
news is that even after these events it usually returns with continual exposure to the sun.
Treatment also includes topical (applied directly to the skin) depigmenting agents such as
hydroquinone,tretinoin and azelaic acid as well as the use of broad spectrum sunscreens and avoidance
of other precipitants such as hormonal triggers.
Also,I wonder if lignin peroxidase which is currently being studied as a lightening agent will
have a role in the treatment of melasma.
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