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Melasma is a skin condition that often affects pregnant women and women taking birth control. It may affect men and women who are not pregnant or taking birth control, although this accounts for only about 10% of melasma cases. Sun exposure can also trigger melasma, which is more common in those with dark complexions.
Melasma Symptoms
Melasma is a skin condition that causes hyperpigmentation on the face, particularly the cheeks, forehead, upper lip, nose and temples. Melasma sometimes occurs on the forearms, though this is rare. The hyperpigmentation is typically dark brown in color, with sharply delineated borders. Markings are symmetrical on both sides of the face. Melasma causes no pain and is not medically dangerous. It is considered a cosmetic problem.

Melasma Causes
Young, pregnant women, or women taking birth control pills, are at the highest risk of developing melasma, especially if they have dark complexions. Pregnant women are susceptible to melasma due to the hormonal changes taking place in their bodies; in pregnant women, the condition is known as melasma gravidum, or “mask of pregnancy.” Women on birth control may experience the condition, because oral contraceptives create a similar hormonal imbalance in the body. Melasma is most common among those who live in hot climates, since sun exposure can exacerbate it.
Melasma Treatment
Using sun protection can help to improve melasma. Sunscreen should be applied to melasma hyperpigmentation to keep the spots from darkening. Skin bleaching creams can be used to treat most cases of melasma. Creams containing hydroquinone are available over the counter. Prescription skin lightening creams contain a higher concentration of hydroquinone, usually 2 to 4%. A stronger skin lightening cream may be prescribed for initial treatment, but a cream that contains 2% hydroquinone should be effective as a maintenance treatment.
If skin bleaching creams aren’t effective for treating melasma, a glycolic acid chemical peel, or trichloroacetic acid chemical peel, may help to remove hyperpigmentation from the face.

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