Chloasma (Gestation Spot, Liver Spot)

Body Parts: Head
Medical Subjects: Skin

What Is Chloasma

What is chloasma?

Chloasma, also known as "cyasma" and "liver spot", is a common acquired disease characterized by symmetrical and irregularly shaped fawn or dark brown spots on the face. Most of the patients are young and middle-aged women. Chloasma is mainly related to ultraviolet radiation and the content of estrogen and progesterone in the body, and has also been shown to have a certain relationship with inheritance. About 90% of patients are women and about 10% are men.


What Is The Cause Of Chloasma

What kind of crowd is chloasma prone to?

It is mainly female (at least 90%) and often occurs in darker skinned people such as Asians, Africans, young and middle-aged women from the Middle East.

Moreover, the darker the skin, the longer the duration of chloasma. In addition, pregnant women and some people with gynecological diseases, chronic liver disease, etc. are more likely to occur chloasma. Male chloasma is mainly related to heredity.

How does chloasma happen?

The pathogenesis of chloasma is still unclear. The following are common risk factors:

  • Female patients accounted for about 90%, increased blood estrogen is the main reason;

  • Oral contraceptives women generally after taking 1 ~ 20 months, pregnant women from pregnancy 3 ~ 5 months began to appear, after delivery can gradually disappear, probably related to progesterone increase in the body;

  • In pregnant women during pregnancy, the secretion of melanocyte-stimulating hormone is increased, resulting in the increase of melanin granules in the skin.

Is the occurrence of chloasma and bask in the sun concerned? Is it seasonal?

The incidence of chloasma is more in spring and summer with strong sunshine, while it will be reduced in winter with weak sunshine. Thus, sun exposure is a contributing factor to chloasma.

Chloasma is often induced by what factors? Cosmetics, contraceptives, bad rest will be induced?

Many factors can play a role in inducing chloasma, such as sun exposure, cosmetics, pregnancy, oral contraceptives and other estrogen increase in the body, in addition, there are chronic liver disease, visceral tumors, hyperthyroidism and other diseases or long-term use of chlorpromazine, phenytoin and other drugs are also common inducing factors. Sometimes chloasma is also obviously related to rest and mental condition, and staying up late, fatigue and mental depression can aggravate the color of the patches.

Can chloasma be infected?

Chloasma is caused by the increase of melanin particles in the upper layer of the dermis of the skin for various reasons, and is not an infectious disease and cannot be infected.


What Symptom Does Chloasma Have

Where does chloasma often occur?

Chloasma occurs mostly in areas easily exposed to sunlight, most commonly in the skin and cheeks at the bilateral cheekbones, and also on the forehead, nose and around the mouth, followed by the forearm. Sometimes the skin darkens at the areola, external genitalia, axillary, and thigh root creases.

What are the main manifestations of chloasma?

Chloasma is generally symmetrically distributed on the prominent parts of bilateral cheekbones: skin and cheek. Sometimes it can also be seen around forehead, nose and lips. Less common than forearm. The patches were in fawn, dark brown or dark brown, with variable depths and shapes, including circles, bars and butterflies.

There was no dandruff on the plaques, and the edges were clear. It often aggravates after exposure to the sun. The incidence of the disease is mostly in spring and summer, but it will decrease in winter.

What feeling does chloasma have after growing?

Long chloasma generally anodyne, no special feeling.

"stretch marks" (long chloasma of pregnant women) will disappear after delivery?

The long chloasma of pregnant women, also known as "cyasma", is usually caused by ultraviolet radiation (sunlight or direct contact with ultraviolet) during pregnancy, and occurs for the first time or the original chloasma symptoms intensify.

In general, the "cyasma" shrinks or even disappears in the lighter-skinned patients during menstruation after delivery, while it may persist in the darker-skinned patients.

Can chloasma become cancer?

Although chloasma is a pigmentary disease, it does not become a cancer like melanoma.

This should be based on the pathological mechanism of chloasma: The pathological feature of chloasma is that the melanocytes in the skin become active, producing more melanin particles than normal skin, which looks like dark patches.

However, cancers with increased pigment, such as melanoma, are related to the deletion of tumor suppressor gene P16 and belong to the malignant proliferation of melanocytes. Trauma, viral infection and low body immunity may all be related to the occurrence and development of melanoma.

What harm can chloasma have to human body?

Chloasma generally does not malignant change, because it is mainly distributed in people's faces, will affect the beautiful, giving people a certain psychological burden.


How To Check Whether Suffering From Chloasma

Does chloasma diagnose need to do an examination?

Chloasma can be diagnosed according to the characteristics of common people and typical clinical manifestations, and no special examination is required.

How is chloasma diagnosed?

It is generally easy to make a diagnosis according to the changes of chloasma caused by skin damage and the characteristics that most patients are young and middle-aged women and most of them occur in bilateral zygomatic parts, cheeks and other places. But it also needs to be distinguished from some facial pigmentary diseases.

What are the diseases that need to be distinguished when chloasma is diagnosed?

  • Freckles: early onset, more than 5 years old children, tan spots, smaller, the general family also have other members with freckles; Freckles and chloasma almost no malignant change;

  • Naevus fuscocaerum zygomatic: blue-brown patches, round or other shapes, more in middle-aged women; Treatment with nevus of ota;

  • Pigmented cosmetic dermatitis: cosmetic that is often associated with cosmetic use and should be stopped immediately first of all for treatment;

  • Melanosis: The patches are bluish gray, with fine dandruff thereon. Sometimes, the patches are fused into a network, and the hair is often distributed in front of ears, temples and forehead. Sometimes, the neck and body can also appear. Avoid substances that may cause allergy, reduce sunlight, and supplement vitamins A and B;

  • Nevus of Ota: The patches are light cyan, dark blue or bluish black, and most of them are distributed unilaterally. The part of eyes with white eyeball can also be seen as bluish blue, and most of them develop disease from childhood; For those with a small scope, liquid nitrogen freezing, chemical exfoliation and skin sharpening can be used, while for those with a larger scope, fuel pulse lasers can be used, such as Q-switched 1064 nm Nd: YAG (yttrium aluminum garnet crystal) laser and Q-switched ruby laser.


How To Prevent Chloasma

Can chloasma be prevented?

  • To prevent chloasma, sun protection is an essential measure. Wearing a sun hat, holding a parasol, applying SPF (sun protection factor) of at least 30 and PA+++ sunscreen on weekdays, especially when the sun is strong, can effectively prevent chloasma. Treatment of chloasma should be strictly protected from light, if not, any other treatment will fail;

  • During pregnancy, proper supplementation of foods rich in vitamin C and vitamin E can also play a role in promoting the regression of the formed plaques;

  • Besides, it is also important to maintain a pleasant and optimistic mood.


How To Treat Chloasma

Where should chloasma go to see a doctor?

Chloasma is a skin disease of pigmentation type, and you should visit a dermatology department, skin beauty center, or medical beauty center of a regular hospital.

Must chloasma be treated?

Since chloasma does not become cancer, treatment is not necessary. However, chloasma grows in the part that is easily exposed to the sun, that is, the part that is easily seen, which affects the appearance of the patient, and even affects the physical and mental health. Therefore, whether to treat chloasma is an independent choice made by the patient after fully understanding his/her condition.

What are the common treatment methods of chloasma?

Chloasma is common, but there is no particularly effective treatment for it. The following are commonly used treatments and are recommended under your doctor's guidance:

  • Oral medication: oral administration of vitamin C, tranexamic acid, or glutathione can inhibit the synthesis of melanin;

  • External decolouring agent: it can act on the active melanocytes to quickly decolour. Such as hydroquinone (1.5%–6%), kojic acid (2%–4%), azelaic acid (10%–20%) and arbutin (3%).

  • Tartaric acid treatment: High concentration of 20%–70% tartaric acid can greatly reduce the adhesion of the skin epidermis and further release to exfoliate the melanin particles. At present, the dermatology out-patient departments of regular hospitals basically carry out tartaric acid treatment programs.

  • External reducing agent: It can inhibit and remove the free radicals causing aging, and reduce the production of dyes and deposition in the skin. The common reducing agent is superoxide dismutase (SOD) cream;

  • Laser treatment: There are different laser treatment options;

  • Cryotherapy: Liquid nitrogen, liquid oxygen, and liquid hydrogen can be used to freeze the skin epidermis to obtain the effect of mild frostbite, and then allow the skin to heal by itself to generate new skin for the purpose of treatment.

What kind of adverse reaction may chloasma have when using fruit acid to treat?

As the tartaric acid treatment uses the stripping effect of the tartaric acid to strip the epidermis of the skin, the 20%–70% high concentration of the tartaric acid can greatly reduce the adhesion of the epidermis of the skin and further release the melanin particles to be stripped. And chloasma is caused by a variety of reasons caused by the increase in melanin particles in the upper layer of the skin.

Fruit acid treatment may have a certain irritation. After treatment with tartaric acid, patients may have facial skin discomfort such as redness, burning sensation, and acupuncture sensation. They should communicate with the medical staff who performed the treatment in time, which generally can effectively relieve or relieve the discomfort.

What are the advantages of using laser treatment of chloasma?

The principle of laser treatment for chloasma is: larger energy destroys the melanin particles in the upper part of the dermis layer of the skin, like breaking small black stones, and then the residue will be swallowed and cleared away by the melanocytes as soon as possible, whereupon the melanin will decrease or disappear.

Laser treatment of chloasma has the following advantages: quick effect, shorter course of treatment than other treatment methods, better effect, and mild adverse reactions. The common lasers for the treatment of chloasma include Q-switched 1064 nm Nd: YAG laser, Q-switched ruby laser, pulsed carbon dioxide laser, and 510nm pulsed dye laser.

What adverse reactions may occur when chloasma is treated with laser therapy?

  • Burning sensation and redness may appear on local skin irradiated by laser;

  • Laser treatment is traumatic to a certain extent, and patients may have certain pain.

  • Facial skin edema may occur;

  • Scar hyperplasia may occur, which is more common in female patients, but the probability of occurrence is small.

Chloasma patients in what circumstances are not suitable for laser treatment?

  • Scar constitution: patients with scar constitution may form local scars after laser treatment, and the results do not outweigh the benefits.

  • For the patients with local infection foci on the skin, laser therapy may enlarge and spread the infection foci;

  • Hemophilia, coagulation function bad patient: completes the laser to be easy to have the hemorrhage not only the situation;

  • Patients with skin allergy, hypertension and heart disease;

  • Women during menstruation, pregnancy and lactation.


What Should The Patient Of Chloasma Notice In Life

What should be noticed after laser treatment for chloasma patients?

  • After the laser treatment, cold compress was applied to the face for about 15 minutes to reduce the burning sensation and redness of the local skin.

  • Strict attention to sunscreen: not only effective for the treatment of chloasma, but also to prevent pigmentation caused by sun exposure after laser treatment;

  • Don't exfoliate your face for a short time after laser treatment.

What should chloasma patients pay attention to in life?

  • Try to avoid direct sunlight on the skin, go out to pay attention to do a good job in sunscreen;

  • Pay attention to rest and ensure adequate sleep;

  • Chloasma is also related to mental factors, the mood upset boredom, will aggravate the condition. So daily to maintain a happy spirit, a cheerful mood;

  • Patients with chloasma should avoid the use of cosmetics during treatment to prevent the aggravation of color spots.

What should the patient of chloasma notice on food?

  • Quit bad habits, such as smoking, drinking, etc.;

  • Balanced diet, balanced nutrition;

  • Drink plenty of water and eat fresh vegetables and fruits.

  • Avoid excitant food, especially coffee, coke, strong tea, etc.

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