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“The mask of pregnancy” - to some this may not be a familiar term, but many women I believe are too familiar with it. This is the term used when referring to melasma in pregnancy.
Melasma is one of the skin conditions that pregnant women might experience due to the change in hormones. By presenting itself in an unattractive way, it causes emotional suffering usually accompanied by embarrassment which affects the future mothers quality of life. Let's dive into this article where I breakdown this topic to you and provide you with treatment options readily available at Dream Clinic so you can unmask your skin.
MELASMA AKA CHLOASMA
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Chloasma or more commonly known as melasma is an acquired pigmentary disorder of the skin. These two terms can be used interchangeably depending on the context. It is a result of melanin overproduction and increased melanin deposition which leads to hyperpigmentation.
MELASMA IN PREGNANCY - WHY DOES IT HAPPEN
The exact mechanism by which pregnancy triggers melasma is not fully understood but it is thought to be the result of hormonal changes involving estrogen and progesterone that take place during pregnancy. Increased sun exposure in pregnancy also causes an increase in melanogenesis which increases the risk of developing melasma.
It affects 50-70% of pregnant women and usually occurs in the second or third trimester.
OTHER TRIGGERS OF MELASMA
Melasma develops when certain conditions/medications trigger melanocytes to go into overdrive. These include :
Genetic predisposition
Sunlight exposure
Some medications: anti-seizure, birth control pills, medications that make the skin more sensitive to sunlight (eg: retinoids)
Thyroid disease
HOW DOES MELASMA PRESENT ITSELF
It presents as hyperpigmented macules, which can be confluent or punctuate and are often distributed symmetrically on both sides of the face.
Melasma can be epidermal, dermal or mixed. Facial melasma lesions can be further categorized based on distribution, which are centrofacial and peripheral. In the centrofacial type, lesions are in the center of the face i.e. the glabellar, frontal, nasal, zygomatic, upper lip and chin areas. In the peripheral type, the fronto-temporal, preauricular and mandibular branch areas are affected.
CAN YOU PREVENT MELASMA IN PREGNANT WOMEN?
It has been scientifically proven that regular application of a broad spectrum sunscreen can effectively prevent the development of melasma in pregnant women.
HOW TO TREAT IT?
If you do end up developing melasma during pregnancy, it is best to seek treatment once you have delivered your precious baby. While melasma may go away on its own, this skin condition can also last for years and due to its appearance it is understandable that many people want to treat it. Treatment of melasma usually requires a combination therapy and here at Dream Clinic all these options are readily available to successfully treat melasma and help you retrieve your glowy beautiful skin.
Oral tranexamic acid Oral tranexamic acid is an antifibrinolytic agent that acts by preventing melanocytes activation due to ultraviolet (UV) light, hormones, and injured keratinocyte. Another mechanism of action of oral tranexamic acid is reduction in vascular proliferation which improves melasma. Several clinical studies show that oral tranexamic acid is an effective and well tolerated treatment of melasma.
Topical treatment Triple-combination cream is considered the gold standard for treatment of melasma and is the only FDA approved drug for topical treatment of melasma. It consists of a combination of fluocinolone acetonide 0.01%, hydroquinone 4%, and tretinoin 0.05%.
Superficial chemical peels Chemical peels are able to bring about excellent cosmetic improvement when used to treat melasma by increasing epidermal turnover. Alpha Hydroxy Acid (eg glycolic acid and lactic acid) or Beta Hydroxy Acid (BHA) are used together with topical treatment for a better response.
Lasers Here at Dream Clinic we have not one but two of the best and innovative laser systems namely, the Fotona StarWalker PQX and the Fotona SP Dynamis NX Line, to treat melasma. The Fotona StarWalker PQX is efficient in removing skin pigmentation while the Fotona SP Dynamis NX Line targets the vasculature which contributes to the development of melasma.
CONCLUSION
Melasma has a significant impact on appearance causing not only physical but emotional distress. For most pregnant women, melasma ends up becoming a very big concern, even though it is not harmful to the health of the pregnant woman, but causes harmful effects on the quality of life of the affected patient. It is important that we make pregnant women aware about this condition and the variety of treatments available to treat it.
Book a consultation at Dream Clinic today where we help you through your journey.
REFERENCES
Lopes, C. C. C. (2022). Prevention of melasma in Pregnant Women: Aspects of approach in Aesthetic Treatment. Epidemiology International Journal, 6(3), 1–9. https://doi.org/10.23880/eij-16000245
Melasma: Diagnosis and treatment. (n.d.). https://www.aad.org/public/diseases/a-z/melasma-treatment
Chloasma--the mask of pregnancy. (2008, October 1). PubMed. https://pubmed.ncbi.nlm.nih.gov/19140277/
Lakhdar, H., Zouhair, K., Khadir, K., Essari, A., Richard, A., Séité, S., & Rougier, A. (2007). Evaluation of the effectiveness of a broad‐spectrum sunscreen in the prevention of chloasma in pregnant women. Journal of the European Academy of Dermatology and Venereology, 21(6), 738–742. https://doi.org/10.1111/j.1468-3083.2007.02185.x
Godse, K., Sarkar, R., Mysore, V., Shenoy, M., Chatterjee, M., Damisetty, R., Shah, S., Vedamurthy, M., Aurangabadkar, S., Srinivas, C., Ganjoo, A., Das, S., & Patil, A. (2023). Oral Tranexamic Acid for the Treatment of Melasma: Evidence and Experience-Based Consensus Statement from Indian Experts. PubMed, 68(2), 178–185. https://doi.org/10.4103/ijd.ijd_266_22
Sarkar, R., Arsiwala, S., Dubey, N., Sonthalia, S., Das, A., Arya, L., Gokhale, N., Torsekar, R. G., Somani, V. K., Majid, I., Godse, K., Ravichandran, G., Singh, M., Aurangabadkar, S., Salim, T. R., Shah, S., & Sinha, S. (2017). Chemical peels in melasma: A review with consensus recommendations by Indian pigmentary expert group. Indian Journal of Dermatology, 62(6), 470. https://doi.org/10.4103/ijd.ijd_490_17