Melasma Flashcards
What is melasma?
A common, chronic skin condition characterized by symmetrical hyperpigmented patches on sun-exposed areas, particularly the face.
What is the primary cause of melasma?
Hyperactivation of melanocytes, leading to excessive melanin production.
Is melasma more common in any particular demographic?
Yes, it is more common in women and individuals with darker skin types (Fitzpatrick types III–V).
Who is most commonly affected by melasma?
Women, especially during pregnancy or hormonal therapy.
People of Hispanic, Asian, and Middle Eastern descent.
What are the main triggers of melasma?
Ultraviolet (UV) radiation: Stimulates melanocyte activity.
Hormonal changes: Pregnancy, oral contraceptives, hormone replacement therapy.
Genetic predisposition: Family history of melasma.
Medications: Photosensitizing drugs like tetracyclines, antiepileptics.
What causes the hyperpigmentation in melasma?
Increased melanogenesis (melanin production) and deposition in the epidermis or dermis, triggered by UV radiation and hormonal factors.
What are the three types of melasma based on pigmentation depth?
Epidermal: Increased melanin in the basal and suprabasal layers; responds well to treatment.
Dermal: Melanin in the dermis; more challenging to treat.
Mixed: Both epidermal and dermal pigmentation.
How does melasma typically present?
Symmetrical, irregularly shaped, brown to gray-brown hyperpigmented macules or patches.
What are the most common locations for melasma?
Centrofacial: Forehead, cheeks, upper lip, nose, and chin (most common).
Malar: Cheeks and nose.
Mandibular: Jawline.
Is melasma associated with itching or pain?
No, it is asymptomatic.
How is melasma diagnosed?
Primarily a clinical diagnosis based on appearance and history.
What tools can assist in diagnosing melasma?
Wood’s lamp examination: Differentiates between epidermal and dermal pigmentation.
Dermatoscopy: Identifies pigment distribution patterns.
Why is sun protection crucial in managing melasma?
UV radiation exacerbates melasma by stimulating melanocyte activity.
What is the first-line topical treatment for melasma?
Hydroquinone: A depigmenting agent that inhibits tyrosinase, reducing melanin production.
What combination therapy is often used for melasma?
Triple therapy: Hydroquinone, tretinoin, and a corticosteroid.
