What is melasma (chloasma)?

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From the FDA Drug Label

HYDROQUINONE USP, 4% SKIN BLEACHING CREAM is indicated for the gradual bleaching of hyperpigmented skin conditions such as chloasma, melasma, freckles, senile lentigines, and other unwanted areas of melanin hyperpigmentation.

  • Melasma is a type of hyperpigmented skin condition.
  • It is characterized by unwanted areas of melanin hyperpigmentation. 1

From the Research

Melasma is a common acquired skin condition characterized by irregular brown or hyperpigmented patches typically located on the forehead, cheeks, nose, chin, and upper lip, as described in the most recent and highest quality study 2.

Definition and Characteristics

Melasma is an acquired skin condition that affects women more frequently, especially those with darker skin tones. It is caused by the overproduction of melanin, the pigment responsible for skin color. The condition is benign but can cause significant cosmetic concerns for those affected.

Pathogenesis and Risk Factors

The pathogenesis of melasma is not completely understood but is thought to be influenced by genetics, UV exposure, thyroid dysfunction, and hormonal influences from either pregnancy or hormonal therapeutic medications, as noted in 3 and 4.

Treatment and Management

The most effective treatment for melasma is a combination approach including strict sun protection, topical depigmenting agents like hydroquinone (2-4%), and sometimes chemical peels or laser therapy for resistant cases, as recommended in the most recent study 2. Some key points to consider in the treatment and management of melasma include:

  • Strict sun protection with broad-spectrum SPF 30+ sunscreen applied daily
  • Topical depigmenting agents like hydroquinone, tretinoin, azelaic acid, or kojic acid
  • Chemical peels or laser therapy for resistant cases
  • Oral tranexamic acid as a promising new treatment for moderate and severe recurrent melasma, as mentioned in 2

Quality of Life and Psychological Impact

Melasma can significantly affect a patient's quality of life and self-esteem due to its disfiguring appearance, as highlighted in 3 and 2. Therefore, treatment is not only significant for improving patient clinical outcomes but is also crucial in improving important psychological and emotional aspects of patients' overall well-being.

References

Research

Melasma Treatment: An Evidence-Based Review.

American journal of clinical dermatology, 2020

Research

Melasma in Latin Americans.

Journal of drugs in dermatology : JDD, 2011

Research

Melasma: an Up-to-Date Comprehensive Review.

Dermatology and therapy, 2017

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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