Melasma is an acquired hyperpigmentation typically seen on the forehead, nose and upper cheek area (there is also a form which appears on the jaw), that mainly affects women. It is also known as the “mask of pregnancy”, and connected to alterations in the estrogen and progesterone levels, typical of this phase in a woman’s life, or use of the combined estrogen-progesterone oral contraceptive pill. In reality it is believed that the cause is mainly genetic and closely linked to UV ray exposure. In some cases it may be linked to the use of medicines. Melanocytes appear only a little larger than usual, while melanin is abundant. Melasma is classified as epidermal, dermal or combined, depending on the depth at which the accumulation of pigment is greatest. Treatment is mainly medical (application of a Galenic solution on the skin every evening) but recurrence or resistence to medical treatment may necessitate a laser treatment which can be carried out with IPL, Q-switched laser, Er:Glass 1540nm laser or ultrapulsed fractional CO2 laser.
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