beauty

Melasma - Cloasma - Gravidic Mask

What is Melasma

Melasma is a typical case of local hyperpigmentation of the skin, which affects more or less extensive areas of the epidermis. It is considered a blemish in all respects, which particularly affects the fairer sex.

In particular, melasma occurs mainly in pregnant women, in these cases, it is therefore called " gravidic mask ". More generally, this skin disorder is known as chloasma .

Fortunately, melasma is only a cosmetic disorder and does not involve any pathological consequences, although it can be an embarrassing and delicate disorder because, in a sense, it goes to "deface" the image of the person.

Incidence

As mentioned, melasma is a condition that mainly affects women (generally young and / or pregnant), but this does not mean that it is a purely female disorder. Indeed, it is estimated that 10% of people who experience this skin pigmentation disorder are men.

In general, melasma manifests itself with a higher incidence in individuals with medium-dark skin, but it cannot be excluded that it also occurs in individuals with very light skin.

Causes

The term melasma designates a condition in which the pigment responsible for tanning, melanin, accumulates in the skin: melanocytes, following an alteration of the synthesis mechanisms, produce an overabundant amount of melanin pigment. Consequently, the skin takes on a spotted appearance, with areas - more or less extensive - characterized by hyperpigmentation.

The causes underlying the alteration of the synthesis of melanin are still not entirely clear, but certainly there are particular factors that can constitute the "trigger" necessary for the development of this form of dyschromia.

These factors will be briefly described below.

Hormonal factors

The manifestation of melasma can be triggered by hormonal factors and, in particular, by imbalances in female sex hormones such as estrogen.

This explains why melasma often affects pregnant women. When melasma occurs in pregnant women, it is more correct to speak of gravidic mask or chloasma.

However, even women who take the contraceptive pill or who follow a hormone replacement therapy may experience melasma, because, even in this case, there is an alteration of the endocrine axis.

Genetic factors

Genetic predisposition plays a fundamental role in determining melasma.

It is shown, in fact, that people with individuals with melasma in their families are more likely to experience this skin hyperpigmentation disorder.

Sun and UV rays

It is assumed that among the main triggers - in addition to hormonal imbalances - is also exposure to UV rays which further stimulate the production of melanin.

Furthermore, sun exposure influences the intensity of hyperpigmentation caused by this disorder: in the winter months melasma is not very evident, unlike the hot months, when the disorder appears already at the first solar exposures. It is opportune to point out that in winter melasma, being a chronic condition, cannot disappear: what changes is the color of the spots, much more evident in the summer. In winter, in fact, the melanin is no longer stimulated by the sun and the color tends to lighten, to become more pronounced in the hot season: the contrast between the dark spots of the melasma and the not-tanned skin is clear, therefore evident.

Stress

According to some hypotheses, stress could also favor melasma: stress is the protagonist of psychosomatic theory, according to which endorphins and enkephalins (endogenous opioid peptides, freed from the brain in case of stress) could favor the hyper-production of melanin. A vicious circle is thus established in which stress triggers the production of endogenous opioids and also becomes a consequence (since the release of endorphins and enkephalins aggravates stress, which in turn worsens melasma). According to this theory, the abnormal and excessive hyper-production of melanin would be due to the excitation of nerve endings in certain areas, as a result of long and considerable periods of stress.

Other factors

Other possible factors that cause melasma are:

  • Thyroid disorders (it seems, in fact, that subjects suffering from thyroid problems are more likely to experience this skin pigmentation disorder).
  • Use of allergenic or poor quality cosmetic substances .
  • Taking some types of drugs .

Signs and Symptoms

A characteristic sign of melasma (or chloasma, in pregnant women) is the appearance of hyperpigmented spots on the skin.

These spots - more or less extensive - are generally of a color varying from light brown to brown. These hyperpigmented patches appear to have a rather irregular shape whose contours are not very defined.

The face, in general, is the most affected area, where the spots are mainly located at the level of the forehead, cheeks, nasal bridge and upper lip (distribution "on a map").

However, there are cases in which the spots also extend to the neck and behind the ears. Very rare - albeit possible - cases in which stains affect arms and legs.

These spots are generally asymptomatic and do not cause any kind of discomfort, except that they represent a decidedly unwelcome and unwanted aesthetic defect for most people.

Treatments

The melasma can have a course of some years, or remain permanent. The cosmetic disorder, in some cases, is decidedly evident: in this regard, some targeted treatments are available, designed to depigment the affected area.

Before any possible treatment, the opinion of the doctor is fundamental: the remedies for melasma are effective in a relatively long time; it is therefore essential to be constant in the treatment and not to suddenly stop the therapy.

Possible remedies can be summarized in:

  • Ointments, creams, gel with lightening action : hydroquinone and kojic acid interfere with the pigmentation processes of melanin. However, there are also side effects resulting from the use of these substances: permanent irritation, dermatitis and hypomelanosis. Due to the poor safety of hydroquinone, the use of the substance is prohibited in cosmetics: only specialists, dermatologists and doctors can prescribe its use. Kojic acid, on the other hand, is allowed in cosmetics, although cases of dermatitis or contact allergy have been reported following the application of the substance.
  • Micro-peeling : it is the most effective treatment against melasma. The micro-peeling speeds up the cellular turnover so that the excess melanin is eliminated: the desquamation stimulates a new cellular synthesis. In this treatment substances such as retinoic acid, glycolic acid and salicylic acid are used.
  • Laser treatments : the treatment with thermal energy against the melasma favors the depigmentation, because it acts directly at the level of the melanin pigment, destroying it. Laser therapy must be performed by a specialist, being dangerous: in fact, if the laser treatment is not performed correctly, scars can remain.
  • Protective creams with sunscreens : UVA and UVB filters protect the skin from sunlight, which could aggravate melasma.
  • Covering creams : rather than a real treatment, covering creams simply hide the disorder, not bringing any effective resolution on the melasma. The choice of cosmetics for people with melasma should be more careful and scrupulous, since it is a skin that is already sensitized: the colored powders, the soils and the dye must be of quality and not formulated with irritants which could make melasma even worse.

Useful tips

The treatment of melasma (or chloasma, depending on the case) - if carried out scrupulously following the dermatologist's instructions - can lead to excellent results. However, to favor the efficacy of the treatment and prevent the deterioration or reappearance of the disorder, dermatologists generally advise to take some precautions:

  • Wear sunscreen every day. In fact, UV rays are always present in the atmosphere - both in summer and in winter - even when you are not exposed to the sun directly. Given the close relationship between sun exposure and melasma, the use of cosmetics with high sunscreens (SPF 30 or higher) can help prevent the problem; or at least, to prevent it from getting worse. Usually, it is advisable to choose solar products that also contain physical filters that are able to reflect ultraviolet radiation.
  • Wear protective clothing such as hats and sunglasses so as to protect yourself from the effects of UV rays. However, we would like to remind you that the use of protective clothing does not replace the use of sunscreens which must in any case be applied.
  • Use cosmetics for delicate and quality skin care, in order to avoid irritation and stress to a beauty that is already sensitive in itself.
  • Avoid waxing . Waxing is an unwanted hair removal method that should be avoided in areas where melasma or chloasma occurs. In fact, the wax could cause skin inflammation, thus worsening the manifestations of this disorder. The dermatologist will be able to advise the patient on what technique to adopt for the removal of unwanted hair in the areas affected by melasma.

Summary

To fix the concepts ...

DISEASEMelasma, called chloasma or gravidic mask when manifested in pregnant women.
HOW IT MAKES ITDark-brownish spots scattered on a map on the face and neck
INCIDENCEEspecially young women and pregnant women
CAUSES
  • Solar exposure
  • Hormonal changes (pregnancy, birth control pills)
  • Irritating cosmetics
  • Stress
  • Genetic predisposition
  • Stress over-excited nerve endings
REMEDIES AGAINST

THE MELASMA

  • Ointments, creams, gel with lightening action: hydroquinone and kojic acid
  • Micro-peeling
  • Laser treatments
  • Protective creams with sunscreens
  • Covering creams