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Melasma

 This is a condition where grey patches develop over the cheeks, nose, chin upper arms, mainly sun exposed areas.  It is increased by pregnancy, oral contraceptive pills and some antiepilepsy treatments. 

 Commoner in women some males may also be affected.  There is no itching, soreness.  The striking nature of this color change is the symmetry of the patches.

 Investigation

None required except wood’s lamp examination if feasible.

Treatment

Usually a combination of sunscreens, bleaching creams tretinoin are prescribed.  Mild topical steroids may be added to this combination.  Oral contraceptive pill must be stopped immediately. 

 Sunscreens should be of the high factor type, > 30 is enough.

1. Q wave switched laser
2. Azelaic acid

MELASMA CLICK HERE