Melanin is the natural pigment found in our skin which governs the colour.  The amount of melanin in pale skinned individuals is minimal, in Asians and Africans it is much higher.


Some individuals can develop large, symmetrical patches of darker pigmented skin in sun exposed areas like the cheeks, upper lip, chin and the forehead.  This is due to excess melanin and is known as melasma and usually occurs in response to higher than usual levels of female hormones. Pregnancy is a common cause of this when the condition is called chloasma.  Women are much more commonly affected than men and people of Asian or Hispanic descent seem to be most commonly affected, but melasma can occur in people of any racial origin.


Melasma can be difficult to treat.  It has a gradual onset and resolves equally slowly so perseverance with treatment is necessary despite not seeing an initial result. Avoidance of excess sunlight and use of sun block is the crucial component of any treatment for melasma. If it occurrs during pregnancy then complete resolution is expected after the delivery, so no specific treatment is required.  In other cases a number of medications applied directly to the skin (topical treatments) have been tried with some degree of success.  A medication called hydroquinone generally reduces skin pigment, and is applied to the skin as a solution. This has proved a mainstay of treatment for melasma.  It needs to be carefully applied as if it is spread over too wide an area then unwanted skin lightening may occur.  Another treatment that may be suggested is with retinoids, which are topical vitamin A based treatments.  Chemical peels are offered aiming to remove pigmentation and rejuvenate the skin.


Melasma is common, especially in pregnancy, but whatever the cause it is important to use sun block and avoid direct sunlight.  If the problem persists then your GP should be consulted for further treatment options.


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