Melasma is an acquired, benign skin pigmentation disorder, locally limited, mostly developing in the face and neck. Melasma appears unevenly in the form of spots on the skin from light brown to dark, black shades, according to Pannochka, an Internet publication for girls and women from 14 to 35 years old.. net Melasma spots have clear contours, mainly located on open areas of the skin. Melasma does not affect mucous membranes. Pigmented spots with melasma do not peel off, the structure of the affected skin does not change. Melasma tends to lighten in autumn and winter. In the spring-summer period of active sun, melasma takes on a brighter shade.. Women are more likely to suffer from melasma. In men, this type of hyperpigmentation is extremely rare, due to the hormonal etiology of this disease.. Melasma can manifest itself as single lesions of the skin, and many spots on the entire open surface of the skin (face, neck, decollete, hands).

Types of melasma There are three classifications of melasma based on clinical, histological, and course of the disease..

So, according to clinical signs (according to the localization of the manifestations of age spots), melasma is divided into three main types:.

Painting - the main foci of skin lesions are localized in the cheeks and nose;

Central facial (centrofacial) - age spots are localized in the forehead, nose, upper lip, chin;

Mandibular - spots of melasma affect the arch of the lower jaw.

By the nature of the course of the disease, melasma is divided into:.

Transient - the spots are temporary and disappear completely after the cessation of the influence of the factor that stimulates the production of melanin and the development of age spots (hormones, sun rays);

Persistent - melasma that goes from a heavier to a lighter form, but does not completely go away.

By histological signs, they are distinguished:.

Epidermal melasma - an increase in the amount of melanin in the layers of the epidermis. Light brown tint of melasma spots brightens under Wood's lamp;

Dermal melasma - an increase in the amount of melanin in the superficial and deep layers of the dermis. This pathology is characterized by spots of an ashen or bluish-gray hue.. Pigmentation doesn't get brighter under Wood's lamp;

Mixed melasma - this pathology is characterized by damage to both the superficial epidermal layers and the deep layers of the dermis. Melasma spots of this genesis are usually dark brown in color, which do not change under a Wood lamp.

Reasons for the development of melasma The main factors that determine the appearance and development of melasma are:.

Ultraviolet radiation - UV rays stimulate the production of melanin (melanogenesis) and the proliferation of melanocytes (skin cells responsible for the production of the pigment melanin);

Genetic predisposition;

Gender;

Hormonal imbalance (taking hormonal contraceptives, pregnancy, ovarian dysfunction);

Dysfunction of the liver, thyroid gland;

Diseases of the gastrointestinal tract;

Therapy with photosensitizing drugs (stimulating the increased sensitivity of the skin to ultraviolet rays);

Disruption of the body's metabolic processes, provoked by an excess or lack of minerals and vitamins;

The use of some cosmetics.

Diagnosis of melasma Melasma is manifested by only one clinical symptom - a group of clearly defined spots on a certain (more often open) area of \u200b\u200bthe skin. When diagnosing a pathological change in order to choose the correct treatment tactics, melasma must be differentiated from such disorders that have similar symptoms and external manifestations, such as:.

Secondary hyperpigmentation;

Pigmented xeroderma;

Poikiloderma skin lymphoma;

Melanosis Riel;

Nevi.

The main method for diagnosing melasma is Wood's lamp, which allows the classification of melasma.

Melasma: treatment, main methods Melasma is characterized by resistance to various treatments. It should be remembered that melasma is a kind of reaction of the body to an irritating factor (excessive radiation, hormone therapy). With melasma, treatment will be ineffective without eliminating the provoking factor. With the passing form of melasma, symptomatic treatment is prescribed, aimed at reducing the manifestations of age spots.

The main treatments for melasma are:.

Drug therapy - the use of topical drugs, the action of which is aimed at inhibiting and inhibiting tyrosinase (an enzyme that catalyzes the synthesis of melanin from tyrosine). The main side effects of topical melasma medications are secondary hyperpigmentation, dermatitis, erythema, burning. This technique is most effective for the treatment of epidermal melasma.;

Injection methods - intradermal administration of drugs that inhibit tyrosinase;

Hardware treatment - the use of light methods (lasers, intense-pulsating installations). This method of treating melasma allows you to selectively affect the melanin contained in pigmented cells, without affecting the surrounding healthy cells.. Laser correction of age spots involves the destruction of micro-areas of the skin, in the place of which healthy cells with normal pigmentation then develop. The main disadvantage of the technique is the increased risk of developing post-traumatic pigmentation of the treated skin areas.. In epidermal and dermal forms of melasma, treatment with hardware techniques is the most effective;

Chemical peels - removal of the upper layer of the epidermis in order to restore the process of skin regeneration and inhibition of melanogenesis. In order to correct age spots, surface and middle peels are used. The use of deep aggressive peeling techniques for the treatment of melasma is not justified, since the effectiveness of the technique is low in comparison with the risk of developing secondary hyperpigmentation.

Melasma: Skinoren treatment In the diagnosis of melasma, Skinoren treatment is one of the most effective methods currently used.. Skinoren is a dermatoprotective agent for external use with a depigmenting, antibacterial, keratolytic, and anti-inflammatory effect..

The main active ingredient in the preparation is azelaic acid, which affects overactive melanocytes due to inhibition of tyrosinase. With melasma, Skinoren treatment is most effective in the early stages of the disease.. Skinoren is available in cream and gel forms with different concentrations of active ingredient. With melasma, Skinoren treatment involves a course of 3 months or more. The main side effects of Skinoren are flushing, burning, itching.. Skinoren is effective for epidermal melasma. Dermal melasma does not respond to treatment with this drug.

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