Melasma (also called Chloasma) typically appears as light brown to dark brown patches, sometimes with a bluish-black or reddish hue.
🔬 It most frequently occurs on the cheekbones compared with other areas of the face. In some cases, freckles—small scattered brown spots—may also be found along with melasma.
There are three main types of melasma:
1. Epidermal type – Occurs in the epidermis. Lesions are dark brown to black-gray with well-defined borders.
2. Dermal type – Occurs in the dermis beneath the epidermis. Lesions appear light brown, gray, or bluish-gray, with ill-defined borders, blending diffusely into the surrounding skin.
3. Mixed type – A combination of both epidermal and dermal melasma on the face.
🧬 Another special form is Vascular Melasma (also called Telangiectatic Melasma or “blood melasma”):
• This form results from abnormal dilation or damage of superficial capillaries in the skin, often triggered by prolonged use of cosmetics or medications containing corticosteroids. This leads to capillary rupture and blood pooling within deep dermal fibrous tissue.
• Clinically, it appears as reddish-brown patches, is considered more difficult to treat, and occurs in women up to 80% more frequently than in men
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