Chloasma

Chloasma Definition

Chloasma is an ordinary skin problem that affects 50-70% pregnant woman and rarely in men. It is commonly known as “mask of pregnancy “or “Melasma.” Defined by dark patches on the forehead, cheek, chin and upper lip, this condition makes affected skin darker, discolored, compared to the standard skin color.

Image Source: www.dermnetnz.org

The affected area is not itchy or painful, but just dark spots. However, the area might get disturbed with some cosmetic products. It is also under consideration that it is an inherited tendency. Hence, hormone therapy, pregnancy, and medications that affect hormone levels and contraceptive pills are said to activate chloasma or melasma.

Who are vulnerable to Chloasma?

People who tend to tan and have a darker complexion are vulnerable to this disease. It mostly occurs during the summer season with excessive sun exposure. The condition develops due to the additional pigment-producing cells in the skin.

Chloasma Causes

The cause of Chloasma is yet unknown, but there are some factors which are blamed for causing this condition are:

• Hormone changes: It is mostly prevalent in pregnant women due to hormonal changes which trigger the production of melanin. It can also occur due to some medication which increases melanin hormone. Improper levels of progesterone and estrogen levels can also cause the problem. Hormone replacement therapy and contraceptive pills can also increase the difficulty.
• UV Rays: Exposure to sun or UV rays is another factor and people living in tropical climates are more likely to suffer.
• Allergy: Allergic reactions due to the application of cosmetics or medications can also trigger melasma.
• Hereditary: People can inherit this skin problem from their parents.
• Addison’s disease: If it is due to skin injury or pressure, chloasma is seen as the first symptom. Thyroid patients also experience this problem.

Chloasma Symptoms

It causes discoloration of the skin. Especially brownish colored spots appear on the:

• Forehead
• Cheeks
• Chin
• Nose

It can also appear on the exposed parts of the surface like the forearm and neck. These spots are not painful, but a patient might suffer from depression due to its appearance.

Image Source: www.dermnetnz.org

Chloasma Diagnosis

Visual examination is adequate to diagnose chloasma. But to know the details and make some clarifications doctors might recommend some instrumental laboratory examinations such as:

• Urine analysis
• Biochemical & general clinical blood test
• Tests for dysbacteriosis
• Microscopic examination of feces
• Ultrasound of the abdominal cavity

The doctor can also check the affected area through wood’s lamp examination. It is an extraordinary light which is held up to the area and allows testing for the fungal, bacterial infections and the layers affected. For further check-up, professionals can also opt for a biopsy involving smaller pieces of the skin affected by testing.

Chloasma Treatment

There is no specific treatment needed as it fades away gradually with time. But regular use of topical retinoids, sunscreen, pigment laser or bleaching cream can help in reducing the pigmentation and patches. It might take some months though. Few medications that can help to treat dark spots and fade them are:

• Tretinoin: A type of vitamin, it helps to expand the procedure of dead skin fall and appearance of new skin. It helps to fade the spots quickly by shedding off the pigmented cells faster.
• Hydroquinone: It is an ointment that helps to take out pigment from the skin. It stops the process of melanin production an element that makes the skin dark.
• Azelaic acid cream: It hinders the pigment production by entirely stopping or slowing down the process.
• Peels: It is a liquid solution that is applied to the affected part of the skin for a mild burn like a sunburn. With time the burned skin peels off parting a new fresh skin. There are a variety of peels, and they vary in strength. Glycolic acid is the mildest amongst all and also has minimum risk of skin discoloration and spotting. It should be kept as the last option and only be used when chloasma does not respond to any treatment. Image Source: www.dermnetnz.org
• Intense Pulsed Light therapy: It uses some rays and lights to remove the spots and the pigmented skin.
• Steroids: Certain type of steroids can be applied directly to the affected areas for stimulation of the pigmented cells. However, this is not successful at times, but it is one of the most straightforward and noninvasive remedies for some people.

Women who breastfeed or are pregnant should not use bleaches, peels or other chemical lightening medications and treatments. They can easily penetrate the skin and be harmful to the baby. Women will see a gradual improvement after the baby is born.

Chloasma Prevention

• Sun Protection: Skin exposed to the sun rays leads to increased pigmentation causing in the darkness of the skin. Use a broad spectrum sunscreen that protects against UVA and UVB rays can protect. If one is outside for a longer duration, it is advisable to reapply several times.
  Also, use a wide hat which will help the skin to protect from the UV rays. Additionally, wearing a long sleeve shirt and covering the exposed area will limit pigmentation and tanning. Avoid going out in the sun between 10 A.M. to 2 P.M.
• Hypoallergic Products (skin care): Face creams and other skin care products can worsen the conditions by irritating the skin.
• Don’t Wax: Removing hair from the skin through wax can cause inflammation and also worsen the condition.
• Application of Concealer: If dark spots are bothering you, apply concealer to hide them. It will make the skin look smooth and concealed temporarily.

Chloasma Pictures

Image Source: www.pcds.org.uk Image Source: www.pcds.org.uk Image Source: www.pcds.org.uk Image Source: en.wikipedia.org