H02.715

Clinical Causes: Excess production of melanin, the pigment responsible for skin color. Prolonged exposure to ultraviolet (UV) light from the sun, which stimulates melanocytes in the skin. Hormonal changes, particularly during pregnancy (often called 'pregnancy mask') or from the use of oral contraceptives and hormone replacement therapy. Genetic predisposition, where individuals with a family history of melasma are at higher risk. Certain skincare products that can irritate the skin or increase sensitivity to sunlight. Underlying thyroid or other endocrine disorders may sometimes be linked with melasma development.

Key Symptoms: Irregularly shaped, symmetrical dark patches on the skin of the left lower eyelid and periocular area. The patches are typically brown or gray-brown in color. Lesions often appear gradually and are more noticeable in sunlight. While primarily a cosmetic concern, some individuals may experience minor skin irritation or sensitivity in areas affected. In most cases, the patches remain stable but can sometimes become darker with sun exposure.

Diagnosis Path: Skin examination to assess the pattern and color of pigmentation. Wood's lamp examination, which uses UV light to differentiate melasma from other pigmentation conditions. Biopsy, in rare cases, to rule out other skin disorders if the diagnosis is uncertain.

Treatment Protocols: Sun protection: Regular use of broad-spectrum sunscreens, sunglasses, and protective clothing to minimize UV exposure. Topical agents: Hydroquinone, tretinoin, corticosteroids, azelaic acid, or other skin-lightening creams prescribed by a healthcare provider. Chemical peels: Mild chemical peels performed by dermatologists can sometimes reduce pigmentation. Laser and light-based therapies: Procedures such as fractional lasers or intense pulsed light (IPL) can help diminish pigmentation but should be used cautiously near the eyes. Avoiding triggers: Limiting hormonal therapies or medications that may exacerbate melasma, under medical supervision.