Melasma

Abstract

Melasma, also known as chloasma or mask of pregnancy, presents clinically as hyperpigmented skin areas, which develop mostly in the face as a consequence of increased synthesis of melanin. The established treatment options, including topically applied agents and the use of various laser systems, mostly result in improvement but not in complete remission of the lesions. Because of its significant impact on quality of life and the limited effectivity of available treatment options, the management of melasma is challenging for the treating physician. Although many risk factors, including pregnancy and UV exposure, have been identified, the pathogenesis is not yet fully understood. Avoiding solar or artificial UV exposure is of high importance both for the prevention of melasma and for the clinical outcome of existing lesions. In order to avoid vitamin D deficiency, oral vitamin D supplementation should be recommended. In this review, we give an update on clinical aspects, epidemiology, pathogenesis and therapy of melasma and give an outlook on future developments.

Melasma

“…3 Women are more likely to develop the condition than men, with the average age of onset between 20 and 40 years, although it can commence in adolescence and is thought to be mediated by hormonal factors. 3,4 As a result of melasma frequently involving the face and the therapeutic challenge in management, the condition has a significant psychosocial impact on patients, with patients reporting shame, reduced self-confidence, anhedonia and a negative influence on interpersonal relationships and work productivity. 4 Treatment often requires a multimodal approach that targets pigment production to achieve equilibrium and disease remission.…”

“…3,4 As a result of melasma frequently involving the face and the therapeutic challenge in management, the condition has a significant psychosocial impact on patients, with patients reporting shame, reduced self-confidence, anhedonia and a negative influence on interpersonal relationships and work productivity. 4 Treatment often requires a multimodal approach that targets pigment production to achieve equilibrium and disease remission. 1 As a result of the high rate of recurrence, maintenance treatments are often essential, with strict light protection required to prevent relapses that characterise this chronic condition.…”

Melasma: A Condition of Asian Skin

“…Oral zinc supplements and zinc screening may be beneficial for the prevention of melasma in high-risk populations. Additionally, Vitamin D levels should be monitored as avoiding UV and sunlight exposure to prevent melasma may cause a decrease in serum Vitamin D. To ensure adequate Vitamin D levels despite avoiding UV sunlight, an oral Vitamin D supplement should be discussed at regular doctor visits [ 32 ]. In a study comparing melasma patients with other co-morbidities, there is a positive correlation between melasma and abnormal serum Vitamin D levels (p<0.050) [ 33 ].…”

Melasma is Associated with Lower Serum Vitamin D Concentrations as Compared to Healthy Controls

“…3 It is due to this avoidance of UV light that vitamin D supplementation is recommended, though the susceptibility of patients with higher Fitzpatrick skin types to develop vitamin D deficiency should also be considered. 5 This is especially true given that these higher skin types are prone to develop melasma. Due to the known influence of vitamin D on melanocytes, 6 and the high prevalence of both melasma and vitamin D deficiency, we aimed to further examine the association between vitamin D status and melasma.…”