Melasma (pregnancy mask) is a disease with irregular borders, brown, discoloration and causes cosmetic appearance disorder. It is especially seen on sun-exposed areas such as the face and neck.
Genetic factors, ultraviolet, systemic diseases, pregnancy, hormonal treatments, sunlight sensitizing drugs and cosmetic substances are held responsible for the development of the disease.
Melasma is common during pregnancy (50-70%) and is also known as the mask of pregnancy.
It is seen in 5-34% of women who are not pregnant and use birth control drugs. Estrogen, progesterone and melanocyte stimulating hormone are thought to be responsible for melasma occurring during pregnancy. The mask of pregnancy usually disappears within 1 year postpartum. However, it can recur and persist in subsequent pregnancies or in those using birth control pills.
Environmental and hormonal factors and the genetic structure of the person are important in the formation of melasma. Studies have reported that familial tendency is 10-50%. In studies conducted in Turkey, familial predisposition has been shown at higher rates. Skin type is also important in pregnancy spots. It has been reported that it is more common in people with dark and very dark skin. No cause-effect relationship was found between gestational age, pre-pregnancy weight, weight gained during pregnancy, gender of the born child and the formation of pregnancy spots.
Melasma is a difficult disease to treat. It usually requires long-term treatment. The aim of the treatment should be to regress the staining, to improve the cosmetic appearance, and to prevent its recurrence. Protection from UV is extremely important both in the effectiveness of the treatment and in the prevention of recurrence. Therefore, absolute sunscreen should be used during and after pregnancy. Birth control drugs and drugs that increase UV sensitivity should be discontinued. In the treatment of blemishes, drug treatments, peeling treatments with chemical peeling, treatment with microneedling (roller), platelet-enriched plasma (PRP) treatment, dermabrasion, laser treatments are applied. Chemical peeling treatments and roller treatments are performed at intervals of 2 weeks, PRP treatment is performed at intervals of 3 weeks, and laser treatments are performed at intervals of 1 month. It is extremely important that these treatments are applied by dermatologists and plastic surgeons. It should not be forgotten that every unconscious and inexperienced treatment may cause significant side effects, as well as cause the spots to come back more intensely and make the treatment more difficult. Most of the postpartum eruption treatments have a peeling effect and it is recommended not to use during breastfeeding. Obstetricians report that laser treatment does not have a systemic effect on the body and can only be used from the 3rd month after pregnancy, as it is a specific treatment for that area. Treatment durations last 4-6 sessions on average. It can be combined with other treatments during treatment. Especially dermatherapy and peeling are effective methods in this direction.
Finally, we can say that melasma is a type of disease that requires patience to be treated, caused by various factors that occur during pregnancy and in normal people. Sun protection is the most important preventive factor.
With the development of medicine, it is no longer an incurable disease group, but can be treated by dermatology and plastic surgery specialists.
