Melasma presents as pigmented patches which develop slowly and, most often, symmetrically on both sides of the face. The patches vary in colour from tan to dark drown.
These patches of hyperpigmentation on the face tend to occur on women older than 30 and women with Mediterranean and South American heritage are at particular risk. Oral contraceptives and/or pregnancy can trigger the appearance of melasma which is commonly called the “mask of pregnancy”). However, melasma has been observed to present independently of these triggers. Melasma is usually brought on by hormonal imbalances but it can occasionally develop in the absence of hormonal abnormalities. Melasma presents under two principal typologies:
▪ Centrofacial type: 63% of all cases (affects the cheeks, forehead, chin and upper lip);
▪ Malar type: 21% of cases (affects the cheeks and nose in a symmetrical presentation).
Both types of melasma appear following exposure to the sun and tend to worsen with age. Depigmentation therapy is best begun in winter. Using different treatments including customised peels and serums, the melasma pigmentation can be gradually lightened and can eventually disappear altogether.