Melasma: Symptoms and Treatment

Melasma is a defect in the skin that is characterized by a pigmentation disorder. This disease does not pose a threat to human life and is benign. Often the manifestation of this dermatological disorder is localized in the face and neck area. Rashes in size are limited and can be either single or multiple. Clearly established age and sexual limitations of the disease, but in most cases, melasma on the face is diagnosed in women, which may be due to the use of steroid hormones. An effective method of elimination can be determined only by the doctor after examination and elucidation of the etiologic factor.


Hyperpigmentation of the type of melasma can be provoked by the following etiological factors:

  • genetic predisposition
  • increased sensitivity to ultraviolet rays;
  • hormonal disruption;
  • pathological processes in the pancreas;
  • liver disease;
  • pathology of the genitourinary system
  • excessive production of melanin;
  • impaired metabolism, which may be due to insufficient amounts of vitamins and minerals in the body
  • the use of unsuitable cosmetic products for the type of skin
  • long-term therapy with photosensitizing drugs

It should be noted that the exact etiological causes that would lead to this dermatological disease, no. To lead to the development of such a pathological process can be as one certain factor, and several at the same time.


Depending on the depth of the lesion of the skin, distinguish such types of melasma:

  1. dermal — contours of spots are rather vague, have a dark brown hue. This form is the least treatable;
  2. epidermal — the easiest form of the disease, the spots have clear outline, light color
  3. mixed — different spots are diagnosed in shape, color and penetration depth.

Based on the localization of the manifestation of a dermatological disease, the following forms are distinguished:

  • central facial — rashes are localized in the forehead, chin, upper lip, nose area
  • painting — the main foci of the disease are in the nose and cheeks;
  • Mandibular — spots are located in the area of ​​the lower jaw.

Also distinguish the forms based on the nature of the disease:

  1. passing — after the elimination of the original cause of the factor, the spots disappear, there is no relapse
  2. persistent — as a result of intensive therapy, spots can become lighter and smaller, but complete cure is almost impossible


As a rule, the specific symptoms that are inherent in most dermatological diseases (itching, burning, peeling) are not present. However, the clinical picture can be characterized by symptoms of the underlying cause. So, for gastroenterological etiology, the symptomatology can be characterized as follows:

  1. weakness, fatigue;
  2. nausea, possibly with vomiting;
  3. changing the frequency and consistency of the stool
  4. abdominal pain
  5. subfebrile body temperature;
  6. Impairment of appetite.

With liver diseases, the above described clinical picture can be supplemented with such signs:

  1. jaundice of the skin
  2. feeling of discomfort and pain in the right hypochondrium.

Even if the spots on the skin do not have any additional symptoms, you should still seek advice from a dermatologist. The exact etiology of this dermatological disease can only be determined by the doctor after the examination.


First of all, a thorough physical examination of the affected skin areas is carried out, with the collection of complaints, an anamnesis of the disease and life. Examination of the skin is carried out with the help of a Wood lamp. To clarify the diagnosis, a biopsy of the affected area of ​​the skin can be prescribed. General clinical laboratory tests, as a rule, have no diagnostic value.

Since the clinical picture is largely similar to other dermatological diseases, it may be necessary to conduct differential diagnosis in order to confirm or deny the presence of such ailments:

  • secondary hyperpigmentation
  • Ryll melanosis;
  • pigmentary xeroderma;
  • nevi of different etiology.

Based on the results of the diagnosis, the doctor can make an accurate diagnosis and prescribe the correct treatment. In some cases, an additional consultation of a gastroenterologist, endocrinologist, oncologist or other narrow specialists may be required.


In most cases, melasma is the body’s response to certain irritating factors. Therefore, the basic therapy will be directed, first of all, to eliminate the underlying cause.

Medication is based on the use of external or injectable drugs that inhibit the effect of tyrosine kinase. However, it should be noted that in some cases such medications can provoke the development of secondary hyperpigmentation or irritation.

In addition to medical treatment, the doctor can appoint such additional procedures:

  1. chemical peeling;
  2. photolifting
  3. Laser peeling.

It should be understood that cosmetic treatments for melasma should be carried out systematically. One or two procedures will not give the proper effect.

In addition to targeted treatment, general recommendations should also be considered:

  • for prolonged exposure to sunlight, cosmetic products should be used to protect the skin from ultraviolet rays
  • Limit the use of cosmetics, which includes retinoids
  • reduce the time spent in the sun, exclude visits to the solarium.

The effectiveness of therapeutic measures will depend on the etiology and form of the disease.

Forecast and Prevention

Melasma does not pose a threat to human life. There are no specific methods of prevention, but you can reduce the risk of developing this dermatological disease if you apply the following in practice:

  1. use sun protection means
  2. timely and correctly treat all diseases
  3. balanced and timely eating
  4. use only high-quality, skin-friendly cosmetics

In addition, you need to systematically undergo a preventive medical examination.