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Melasma (pregnancy mask)

Definition: Form of hyperpigmentation that tends to appear during pregnancy or in women who take oral contraception (hormonal disorders), although it can develop in anyone. Mostly present in women, melasma can also develop in men. In addition, dull to dark skin types are among the most affected by this phenomenon. Pregnancy mask usually appears as large irregular dark patches on the face, especially on the cheeks, bridge of the nose, forehead and upper lip. Other parts of the body may also be affected, such as the stomach or the forearms. This is only an aesthetic problem; the patches are neither painful nor itchy. These patches have no relation to sunspots. The pregnancy mask is the result of the production of too much melanin, a pigment produced by specialized skin cells called melanocytes. There are three types of pregnancy mask: "epidermal melasma" which is the most superficial form with hyperpigmentation of the epidermis, "dermal melasma" which concerns the dermis, and "mixed melasma" which is characterized by both epidermal and dermal melasma.
Internal and external causes: Repeated exposure to the sun, hormonal changes (during pregnancy, after taking the contraceptive pill, hormone replacement therapy), genetic predisposition, certain drugs which increase the skin’s sensitivity to the sun (for example anti-epileptic drugs), autoimmune thyroid diseases.
How to reduce or eliminate: Consult a dermatologist; apply sun protection with a sun protection factor greater than or equal to 30; use dermo-cosmetic treatments containing active ingredients with a depigmenting action (azelaic acid, tranexamic acid, kojic acid, niacinamide, arbutin acid, vitamin C, liquorice extract, etc.) and with exfoliating properties (glycolic acid, salicylic acid, gluconolactaone). These topical treatments are only effective if the hyperpigmentation affects the upper layers of the skin; dermatological treatments (injection of depigmenting peptides, chemical peels with glycolic acid or trichloroacetic acid, laser, pulsed light, prescription of depigmenting creams based on hydroquinone, azelaic acid, tretinoin or corticosteroids, prescription of tranexamic acid orally); If the skin is well protected from the sun, the pregnancy mask can spontaneously disappear during the first few months after childbirth or after stopping an oral contraceptive; Avoid grain scrubs which can aggravate melasma.
Preventative steps to take: Limit time spent in the sun; do not expose yourself to the sun during the most intense hours (between 11 a.m. and 3 p.m.); wear clothing and hats to protect against the sun when possible; apply broad spectrum (UVA/UVB) sun protection with an SPF greater than or equal to 30 daily, even on cloudy days.

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