Melasma

Conception

It is also called liver speckle, pregnancy speckle, butterfly speckle and epidermis speckle, tawny dot-like or patch-like pigmentation, symmetrically distributing in cheeks and forehead.

Clinical feature

1. Tawny pigmentation occurs in face, always in forehead, cheek, nose and upper lip and appears symmetrically.
2. Tawny;
3. At first the pigment spots appear, some can be gradually integrated.
4. Related to sunshine, season and incretion.
5. Not elevate the skin or pit in the skin. No symptoms, no self-healing tendencies;

Etiology

1. Female in the gestation.
2. Female taken contraceptive.
3. sunshine.
4. Patients with chronic liver disease and other chronic disease.
5. Take neuroleptic etc.

Histopathology

The melanin increases in the epidermis or the dermis or both of them.

Method of treatment

1. Take Vitamin C, Vitamin E
2. 1.5-4% external hydroquinone cream(twice per day) (Pay attention to keeping it from light and the bottle sealed).
3. You can take 0.05-1% tretinoin for long term.
4. The lesions of melasma are in the dermis or epidermis, so Q-Switched Nd:YAG laser 1064nm or 532nm is especially great when treating this kind of disease. However, some patients will appear obvious pigmentation and the pigmentation will dispel days later. So the trial treatment is very necessary (you should have the trial lesions treatment on 0.5-1cm²) .And if it works, keep treating, or you have tostop and adopt the above 3 ways.
5. Single pulse 400mj Q-switched ND:YAG laser and Pmise-1064QA with large spot to treat many times or SR tip, long-term effect is obvious.