ABSTRACT

Melasma belongs to the acquired hyperpigmentation skin diseases. It is a common dyschromia located on sun-exposed areas, mainly on the face and occasionally on the neck and forearms. Melasma is due to the increased focal epidermal activity of melanocytes producing melanin, and microscopically there is increased melanin in epidermal keratinocytes and/or dermal macrophages. The diagnosis of melasma is made clinically. Laboratory examinations and biopsy are required only in the case of an uncertain diagnosis to exclude other hyperpigmentary diseases. Treatments for melasma can be categorized as topical bleaching agents, lasers, and other treatments, including chemical peeling and experimental therapies. The key principles of therapy include the inhibition of the activity of melanocytes, the inhibition of the synthesis of melanin, the removal of melanin, and the disruption of melanin granules. The successful management of melasma relies on highlighting the importance of avoiding precipitating exogenous factors. UV and visible light can initiate or aggravate melasma.