Melasma
Melasma
Melasma, also known as the “mask of pregnancy,” is an acquired hyperpigmentation disorder most commonly seen in young to middle-aged women. It is strongly influenced by ultraviolet and visible light exposure, which activate hyperfunctional melanocytes to overproduce melanin. Hormonal influences such as pregnancy, oral contraceptive use, and hormone replacement therapy exacerbate the condition, highlighting the role of estrogen. Clinically, hyperpigmented patches are accentuated under Wood’s lamp, helping identify epidermal involvement. Management begins with strict broad-spectrum sun protection. Topical therapies include hydroquinone, often in combination with a topical corticosteroid and a retinoid, as well as kojic acid, azelaic acid, and oral tranexamic acid at 325 mg twice daily, though systemic therapy carries risks of venous thromboembolism and cerebral infarction. Procedural options include chemical peels and fractional laser or intense pulsed light therapy for resistant cases.
Melasma
- Pregnant woman wearing a dark Mardi Gras mask = Melasma (“mask of pregnancy”)
- Young woman = Young to middle-aged woman affected
- Wearing 3D glasses + sun = UV irradiation and visible light activate hyperfunctional melanocytes to produce more melanin
- Female symbol = Increased estrogen (pregnancy, OCPs, HRT) can exacerbate melasma
- Holding a purple light wooden lamp = Epidermal areas accentuated with Wood’s lamp
Treatment
- Sunscreen = Broad-spectrum sun protection/avoidance
- Hydro-Queen = Topical hydroquinone
- Cooler = Topical steroid
- Asteroid = Topical retinoid
- Kojic King holding acid = Kojic acid
- Azalia = Azelaic acid
- Teacher holding exam = Tranexamic acid 325 mg twice daily
- Clots of dirt = Venous thromboembolism
- Brain hat with a black stroke = Cerebral infarction
Procedures
- Facemask = Chemical peels
- Laser = Fractional laser/IPL