CHLOASMA

TYPES

There are four different types of Chloasma, the most common of which is the dentofacial type, which can be found in the forehead, cheeks, bridge of the nose, and upper lip. This appears as a brown or tan pigment scattered over the areas as mentioned above.

• Chloasma found on the superficial layer of the skin called the epidermis.
• Chloasma found on the second layer of the skin called the dermis. During direct examination of the skin biopsy under the microscope, several cells are found to contain melanin, thus named melanophages.
• Chloasma that involves both layers of the skin (epidermis and dermis)
• Over secretion of melanin by the melanocytes usually apparent among dark-skinned individuals

SYMPTOMS

The presence of brownish patches with irregular borders located on the area of the cheekbones, forehead, bridge of the nose and the upper lip towards the tip of both lips are sometimes the only symptoms that are present in Chloasma. The size can range from 0.5 to 10 cm at its largest. Any other signs and symptoms do not accompany it except for the symptoms associated with pregnancy itself.

DIAGNOSIS

Identifying the appearance of the Chloasma is the most common diagnostic tool. The clinician, however, may use a tool called the Wood’s lamp to distinguish the presence of the melanocytes on either layer of the skin. The light uses 300-400nm UV wavelength.

TREATMENT

There are several treatment options for the removal or lightening of Chloasma, and these include:

• The use of Hydroquinone cream applied over the skin inhibits the production of the substance tyrosine that inhibits the activation of melanocytes.
• Tretinoin and Azaleic acid cream topically inhibit the release of the pigment melanin from cells that produce them. Tretinoin, however, is not used during pregnancy, as this causes some congenital disabilities.
• Over the counter soaps containing kojic acid and glutathione helps lighten the melasma but can take up to several weeks and tons of patience to achieve the desired results.
• Undergoing dermabrasion, this enables thorough treatment from the most superficial layers of the skin to the deepest.
• Skin rejuvenation treatment- use of a series of medications that are applied topically and after 3-4 weeks causes the resurfacing of new skin cells, sloughing off the layer where the Chloasma is located.