Overview of Melasma

About 90% of women are affected by melasma. It is considered as one of the common skin diseases that can be treated by topical, laser and other kinds of therapies.

Signs and Symptoms of Melasma

Melasma also known as (Kalay Dagh / کالےداغ ), commonly forms dark brownish patches on the skin due to hyperpigmentation, particularly on the face.  It can also affect other areas of the body such as:

  • Forearms
  • Neck
  • Shoulders

Another name of melasma is “chloasma” and also called “mask of pregnancy, (during pregnancy).  The condition is more prevalent in women than in men.

Prevalence of Melasma

The American Academy of Dermatology defines that melasma is commonly present in 90% of women and 10% cases of men worldwide. Generally, it begins from the age of 20 to 40. People with dark complexion  and  pregnant women are at high risk of this skin problem.  The prevalence rate varies from region to region, depending upon the population analysis of skin tone or sensitivity of melasma in pregnant women.  In rare cases, melasma may appear in children.

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Types of Melasma

The associated signs and symptoms have not been observed in melasma patients. Only the brown or grey-brown patches forms on different areas of the face are as follows:

  • Forehead
  • Cheeks
  • Bridge of the nose
  • Around upper lips
  • Chin

Less commonly,  patches appear on forearms, shoulders or neck areas.

Causes of Melasma

The skin consists of two layers, epidermis and dermis. The types of melasma  based on these two skin layers in which the pigmentation pattern is different from each other.

Epidermal melasma: This type represents the production of excess melanin in the epidermal layer of the skin.  It is characterized by:

  • Well-organized border
  • Dark brown colour
  • Appears more clear under black light of UV lamp
  • Responds well to treatment

Dermal melasma: This type is identified as melanophages (cells that ingest melanin) present on the dermis layer. Characteristics of recognition are:

  • Irregular pattern on the border
  • Light brown or bluish
  • Unchanged under black light
  • Responds poorly to treatment

Mixed melasma: It is the combination of both the epidermal and dermal type, which is characterized by

  • Most common type among both types
  • Combination of bluish, light and dark brown patches
  • A mixed pattern is seen under black light
  • Partial improvement with treatment

Risk Factors of Melasma

What causes  melasma is not clearly known. Generally, the females with dark-skinned tones are more prone  to this disease as compared to fair tone females. Especially, people living in Latin/Hispanic, North African, African-American, Asian, Indian, Middle Eastern, or the Mediterranean affect more. However, there are a list of triggers that enhances the melamasa of these people at different conditions such as:

  • Hormonal changes such as overproduction of estrogen and progesterone
  • By using birth control pills, taking hormone therapy or hormonal changes during pregnancy can enhance melasma
  • In stress condition and thyroid disease
  • Skin exposed to the sun because ultraviolet rays effect on the melanocytes cells and cause excessive pigmentation
  • By using some skin products that a person may allergic to them
  • A person can get melasma inheritably

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Some of the ways that can help to prevent melasma include:

  • Avoid using harsh skincare products including sopas etc
  • Limit direct exposure to sunlight
  • Don’t go for tan baths
  • Always apply sunscreen while staying outdoors
  • Avoid hormone containing birth control pills

Treatment of Melasma | When to Consult a Doctor

The diagnosis of melasma is rapidly conducted by visual examination of skin and skin biopsy if required. After visual inspection of the skin through wood’s light, a dermatologist can recommend a skin biopsy to rule out other skin diseases.
A skin biopsy is performed to scrap a small fragment of skin from affected women and the samples sent to labs for further analysis.

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Last updated on Wednesday 07/12/2022


Dr. Asif Rauf

Cosmetologist, Dermatologist | MBBS

Cosmolux ( The Hair & Skin Clinic )Rs 2000


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Highly Recommended


Dr. Farrukh Aslam

Cosmetologist | MBBS, FCPS, BFIRST Fellow, MRCPS, FACS

LaForma ClinicRs 1500


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Dr farukh is a kind man he listen whatever i said and then he diagnosed me the treatment of my issue


Dr. Aamir Chhipa

Cosmetologist, Dermatologist | MBBS, DCDD

Dr Aamir Skin ClinicRs 1000


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I am very satisfied with the overall doctor's experience.

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