Dermatology -Melasma

Dermatology -Melasma  
Melasma is a sun-induced hyperpigmentation, usually on the face, that is acquired and appears as light- or dark-brown. In addition to being idiopathic, melasma can also be linked to pregnancy, oral contraceptives, or drugs like diphenylhydantoin. People with darker skin tones tend to have melasma more frequently; women account for 90% of instances. A synonym is chloasma.

a macular hyperpigmentation, usually uniform but sometimes blotchy, that is primarily well defined in the frontal and malar regions of the face.
Clinical diagnosis is done, and post inflammatory hyperpigmentation is included in the differential.

Topical therapies include azelaic acid 20% cream, hydroquinone 3% solution and 4% cream, and a combination of tretinoin 0.05%, hydroquinone 4%, and flucinolone 0.01%.
The pharmacist can combine hydroquinone 4% cream with glycolic acid cream or 0.05% tretinoin cream. Use of monobenzylether or other hydroquinone ethers (monomethyl- or monoethyl-) should be avoided as these ethers might produce a disfiguring patchy leukoderma and result in a permanent loss of melanocytes. Sunscreens can help prevent melasma.