Abstract
Melasma is one of the most common hyperpigmentation disorders, primarily affecting women of reproductive age. It tends to be more prominent in individuals with darker skin tones, typically in a symmetric pattern on the face and neck. The pathogenesis is still unclear. Possible etiologic agents include UV radiation, hormonal changes related to pregnancy or thyroid abnormalities, as well as antiseizure and photosensitive medications. Increased melanocyte number and/or excess melanin production may be involved in the pathophysiology of this disorder. Th ere are many therapies for melasma, including hypopigmenting agents, chemical peels, dermabrasion, and various types of lasers. Preventative modalities should also be considered in the management of this condition, such as minimization of UV exposure and avoidance of certain drugs when possible. Elucidation of the pathogenesis of this condition may lead to better, more specific treatments.
SEARCH METHODOLOGY: We performed a PubMed search for all articles relating to "melasma" and "chloasma" and found 75 articles of particular interest. We have also evaluated many other articles and book chapters as well. Pertinent evidence-based information relevant to the epidemiology, etiology, diagnosis, and therapeutic management of the disorder were selected and included in this chapter.