What is the cause of melasma?

If you want to remove chloasma, you should pay attention to the cause. Only by understanding the cause can you take preventive measures. Common causes of chloasma include decreased estrogen levels, endocrine disorders, or long-term use of contraceptives, all of which may cause chloasma to form.

1. Causes

The appearance of chloasma is mostly related to endocrine, especially the estrogen level in women. Chloasma may occur due to irregular menstruation, pregnancy, taking birth control pills, poor liver function and chronic kidney disease. In addition, sun exposure and mental factors can aggravate the disease. Pregnant women often develop chloasma after 3 months of pregnancy, and in most cases, the condition gradually disappears when menstruation returns to normal after delivery. If it persists for a long time, treatment is needed.

2. Differential diagnosis

Melasma needs to be differentiated from freckles, post-inflammatory pigmentation, malar nevus, melanosis, pigmented lichen planus, etc.

3. Symptoms and signs

It is more common in women, especially during pregnancy, postpartum and those taking oral contraceptives. The rash is symmetrically distributed on the face, forehead, cheeks, both sides of the nose, around the lips, and chin. It is irregularly shaped, light brown or dark brown spots ranging in size from fingertip to coin or palm, with distinct or blurred boundaries and can merge into large patches. There are no subjective symptoms, the disease lasts for a long time and worsens after sun exposure. Some of them may slowly disappear after childbirth or discontinuation of contraceptive pills.

4. Disease treatment

The treatment of melasma requires a combination of internal and external methods. First, the cause must be eliminated and strict sun protection must be applied. The most effective topical medication is the Kligman formula: 5% hydroquinone, 0.1% tretinoin, and 0.1% dexamethasone. Commonly used ones are silk white freckle cream and hydroquinone cream. There are some whitening and freckle-removing cosmetics on the market that contain arbutin, vitamin C/E and their derivatives, some plant flavonoids and polyphenol extracts, niacinamide and other whitening ingredients, which also have certain effects when applied externally and can be used in combination. Whether it is whitening cosmetics or medicines, it takes at least two months of use to see the effects, and you need to persist. In addition, there are fruit acid peels [1]. Treatments such as vitamin C ion introduction also have relatively good therapeutic effects. There are also some Chinese medicines such as Jiawei Xiaoyao Powder and Taohong Siwu Decoction that may be helpful. These medicines need to be taken for a long time and will not be effective in the short term. In short, the treatment of melasma is quite difficult and requires patience and gradual adjustment.