ABSTRACT

Melasma is a common, acquired hypermelanosis characterized by irregular light-brown to gray-brown macules and patches on the sun-exposed areas of the skin. Hyperpigmentation is seen mostly on the face and occasionally in the neck and forearms. Although no gender, age or ethnic group are free from this disease, melasma is far more frequent in women, dark-skinned individuals and people living in high ultraviolet-index countries. The etiology of melasma has not been clearly identified. The major etiologic factors in the pathogenesis of melasma include genetic influences, exposure to ultraviolet radiation, and female sex hormones. Other factors associated with melasma include pregnancy, oral contraceptives, hormone replacement therapy, thyroid autoimmunity, cosmetic ingredients, phototoxic drugs, anti-epileptic drugs, hepatic dysfunction, endocrinopathies, nutritional deficiency and emotional factors.