Melasma - acquired benign skin pigmentation disorders, locally limited, more
growing extent in the face and neck. Melasma appears uneven in spots on the skin from light brown to dark black color. Spots with melasma have clear contours, are mainly located in the open areas of the skin. Melasma does not affects the mucous membranes. Brown spots in the melasma not shelled structure affected skin does not change. Melasma tends to lighten the autumn-winter period. In the spring and summer sun active melasma becomes brighter hue. Most melasma affects women. In men, this type of hyperpigmentation is very rare, due to the hormonal etiology of this disease. Melasma may appear as single lesions in the skin, and lots of spots all over the exposed surface of the skin (face, neck, décolleté, hands).
The types of melasma
There are three classifications of melasma, based on clinical, histological features and nature of the disease.
Thus, clinical signs (localization manifestations age spots) Melasma is divided into three main types:
- Paint - basic skin lesions localized in the cheeks and nose;
- Central front (tsentrofatsialnaya) - pigment spots are located in the forehead, nose, upper lip, chin;
- Mandibular - spots melasma striking arc of the mandible.
By the nature of the disease melasma is divided into:
- Passing - spots are temporary and disappear completely after the cessation of exposure to the factor that stimulates the production of melanin and the development of age spots (hormones, sunlight);
- Persistent - Melasma, moving from heavier to lighter form, but it does not pass completely.
On histological features distinguish:
- Epidermal melasma - increase the amount of melanin in the epidermis. Light brown shade spots melasma becomes brighter under Wood's lamp;
- Dermal melasma - increase the amount of melanin in the superficial and deep layers of the dermis. This pathology is characterized by patches of ash-gray or bluish tint. Pigmentation becomes brighter under Wood's lamp;
- Mixed melasma - this pathology is characterized by lesions of both superficial epidermal layers and deep layers of the dermis. Spots melasma this genesis is usually dark brown in color, do not change under the Wood's lamp.
The causes of melasma
The main factors determining the emergence and development of melasma are:
- Ultraviolet radiation - UV rays stimulate the production of melanin (melanogenesis), as well as the proliferation of melanocytes (skin cells responsible for production of the pigment melanin);
- Genetic predisposition;
- Violation of hormonal (hormonal contraceptive, pregnancy, ovarian dysfunction);
- Abnormal liver function, thyroid gland;
- Diseases of the gastrointestinal tract;
- Therapy photosensitizing drugs (stimulating increased sensitivity of the skin to UV rays);
- Violation of metabolic processes of the organism provoked by an excess or deficiency of minerals and vitamins;
- The application of some cosmetics.
Diagnosis of melasma
Melasma appears only one clinical symptom - a group of well-defined spots at a certain (usually open) area of skin. In the diagnosis of pathological changes to choose the right tactics treatment of melasma must be distinguished from such disorders with similar symptoms, and symptoms such as:
- Secondary hyperpigmentation;
- Xeroderma pigmentosum;
- Poykilodermicheskaya lymphoma of the skin;
- Melanosis Riehl;
The main method of diagnosis of melasma - Wood's lamp, which allows to classify melasma.
Melasma: treatment, basic methods
It is characterized by resistance to various treatments. Keep in mind that melasma is a kind of reaction to the irritant (excessive radiation, hormone therapy). If melasma treatment will be ineffective without addressing provoking factor. When running the form of melasma treatment is given symptomatic manifestations aimed at reducing age spots.
The main methods of treatment are melasma:
- Drug therapy - the use of topical drugs that target inhibition and inhibition of tyrosinase (the enzyme that catalyzes the synthesis of melanin from tyrosine). The main side effects of topical preparations for the treatment of melasma are secondary hyperpigmentation, dermatitis, erythema, burning sensation. This technique is most effective for the treatment of epidermal melasma;
- Injection methods - vnturikozhnoe administration of drugs which inhibit tyrosinase;
- Hardware treatment - the use of light techniques (lasers, intense pulsed installation). This method allows the selective treatment of melasma affect melanin contained in pigmented cells without affecting the surrounding healthy cells. Laser correction of age spots involves the destruction of micro-skin on the ground which then develop healthy cells with normal pigmentation. The main drawback of the method is an increased risk of developing post-traumatic pigmentation of the treated skin areas. When the epidermal and dermal forms of melasma treatment hardware techniques is the most effective;
- Chemical peels - the removal of the top layer of the epidermis to restore the skin regeneration process and oppression melanogenesis process. To correct age spots are used the surface and mid peelings. The use of aggressive deep peeling methods for the treatment of melasma is not justified, as the efficiency of the method is small compared with the risk of secondary hyperpigmentation.
Melasma: treatment skinorenom
In the diagnosis of melasma treatment skinorenom it is one of the most effective methods currently in use
. Skinoren - dermatoprotektornoe agent for external use, having depigmenting, antibacterial, keratolytic and anti-inflammatory effect
. The main active ingredient in the drug is azelaic acid, have an impact on the hyperactive melanocytes by inhibiting tyrosinase
. If melasma treatment skinorenom most effective in the early stages of the disease
. Skinoren available in cream and gel form with different concentration of active ingredient
. If melasma treatment skinorenom involves courses lasting from 3 months
. The main side effects are skinoren hyperemia, burning, itching,
. Skinoren is effective for epidermal melasma
. Dermal melasma is not treatable with this drug