Sun-related spots can appear in different ways. The most common of these is melasma, also known as pregnancy spot or pregnancy mask.
Melasma is a relatively common disease that occurs in areas exposed to the sun, especially on the face, and is accompanied by darkening of the skin. It is more common in dark-skinned women, especially those living in areas where UV rays are intense.
Although the exact cause of melasma is unknown, pregnancy, birth control pills, genetics, sun exposure, some cosmetic products used, thyroid dysfunction, and antiepileptic drugs. Many factors, such as medications, may be responsible for its occurrence. Melasma occurs in approximately 75% of pregnant women and is the most disturbing cosmetic change related to pregnancy.
In idiopathic melasma, which is not related to pregnancy or oral contraceptive use, mild hormonal changes or ovarian dysfunction may be responsible for the emergence of the disease. . Melasma can also be seen in men, it shows the same clinical and histological features as women, but the role of hormonal factors is not very obvious in men.
The diagnosis of the disease is made by clinical findings. Melasma patients typically have patchy dark spots on the face (cheeks, forehead, upper lip and chin).
Melasma is classified as epidermal, dermal and mixed according to the location of the melanin pigment in the skin. If the pigment cells are epidermally located, the stain darkens under Wood's light, whereas if they are dermally located, no color change is observed. In the mixed type, it is observed that the color darkens in some areas while the color does not change in some areas. In daylight, the epidermal form appears as light brown, the mixed type as dark brown, and the dermal type as blue-grey. The epidermal form responds better to lightening treatments and chemical peeling.
TREATMENT
Melasma treatment is difficult due to the chronic and recurrent nature of the disease. To control the disease, long-term topical lightening treatments and maximum sun protection must be provided. Although pregnancy-related melasma usually subsides within 1 year, dark spots may remain in some areas. can.
Bleaching agents are generally recommended for the treatment of melasma. No matter which treatment is applied, sunscreens with high protection factors should be added to this treatment. To increase the effect, it is necessary to use products containing protective agents against both UVA and UVB. Additional precautions such as wide-brimmed hats and umbrellas should also be used to increase sun protection.
Hydroquinone, azeleic acid, tretinoin and kojic acid are generally used as color lighteners. The chance of success may increase with the combined use of these agents. Mesotherapy and subcutaneous injection of substances that prevent pigment formation are also very effective in lightening color. Although laser treatment is effective in some cases, it is not widely used
Benign pigmented lesions
Benign pigmented lesions and melanocytic nevi (moles) are common benign pigmented lesions in children and adults. Benign pigmented lesions consist of lentigines, cafe-au-lait spots (coffee with milk spots), Beker's nevus, Mongolian spot, Ota and Ito nevi.
Lentigos are benign pigmented lesions that occur due to increased activity of epidermal melanocytes. Unlike freckles, which appear in fair-skinned children and disappear when they are not exposed to the sun, lentigines are permanent. There are two types of lentigos, simple lentigo and solar lentigo. Melanotic macules located in the mucosa are also examples of simple lentigo.
Simple lentigo:Simple lentigos are generally smaller than 5 mm in diameter, sharply demarcated, round-oval, brown or brown-black spots and appear in childhood. Typically there are few lesions and there is no tendency to favor sun-exposed areas. When there are many, different syndromes should come to mind.
Mucosal melanotic macule: Mucosal melanotic macules are frequently observed in young women and are mostly located at the vermillion border of the lower lip. Apart from this, it can also be observed in the oral mucosa and genital mucosa. When their numbers are high, Peutz-Jeghers and Laugier-Hunziker syndromes should come to mind. Multiple genital melanotic macules It is part of the Bannayan-Riley-Ruvalcaba syndrome.
Solar lentigo — Unlike simple lentigines, solar lentigines appear in sun-exposed areas such as the face, outer skin of the hands, forearms and upper body. Since the incidence of solar lentigines increases with age, they occur more frequently in older patients. It can also be observed in fair-skinned children after excessive sun exposure.
CAFÉ-AU-LAIT MACULES (coffee stains) are flat, light brown macules that appear at birth or in early childhood. While it can accompany some genetic syndromes, it can also be found alone in 25-30% of cases. Their sizes can vary from a few mm to 15 cm. As the child grows, these spots tend to expand.
BECKER NEVUS — These lesions, which usually appear during adolescence, are 5 times more common in men than in women. It usually occurs unilaterally in the form of plaques with a diameter of approximately 10 cm on the shoulders and upper body. Black hairs and acne-like lesions can be observed around the lesion.
DERMAL MELANOCYTOSIS — When melanocytes, which normally should be found in the upper layer of the skin, are in the dermis, the lesions we encounter appear bluer.
Sun-related spots can appear in different ways. The most common of these is melasma, also known as pregnancy spot or pregnancy mask.
Melasma is a relatively common disease that occurs in areas exposed to the sun, especially on the face, and is accompanied by darkening of the skin. It is more common in dark-skinned women, especially those who live in areas where UV rays are intense.
Although the exact cause of melasma is unknown, many factors such as pregnancy, birth control pills, genetics, sun exposure, some cosmetic products used, thyroid dysfunction, and antiepileptic drugs may be responsible for its occurrence. Melasma occurs in approximately 75% of pregnant women and is the most disturbing cosmetic change related to pregnancy.
Idiopathic melasma not related to pregnancy or oral contraceptive use also occurs. Mild hormonal changes or ovarian dysfunction may be responsible for the emergence of the disease. Melasma can also be seen in men, it shows the same clinical and histological features as women, but the role of hormonal factors is not very obvious in men.
The diagnosis of the disease is made by clinical findings. Melasma patients typically have patchy dark spots located on the face (cheeks, forehead, upper lip and chin).
Melasma is classified as epidermal, dermal and mixed according to the location of the melanin pigment in the skin. If the pigment cells are epidermally located, the stain darkens under Wood's light, whereas if they are dermally located, no color change is observed. In the mixed type, it is observed that the color darkens in some areas while the color does not change in some areas. In daylight, the epidermal form appears as light brown, the mixed type as dark brown, and the dermal type as blue-grey. The epidermal form responds better to lightening treatments and chemical peeling.
TREATMENT
Melasma treatment is difficult due to the chronic and recurrent nature of the disease. To control the disease, long-term topical lightening treatments and maximum sun protection must be provided. Although pregnancy-related melasma usually subsides within 1 year, dark spots may remain in some areas.
Bleaching agents are generally recommended for the treatment of melasma. No matter which treatment is applied, sunscreens with high protection factors should be added to this treatment. To increase the effect, it is necessary to use products containing protective agents against both UVA and UVB. Additional precautions such as wide-brimmed hats and umbrellas should also be used to increase sun protection.
Hydroquinone, azeleic acid, tretinoin and kojic acid are generally used as color lighteners. The chance of success may increase with the combined use of these agents. Mesotherapy and subcutaneous injection of substances that prevent pigment formation are also very effective in lightening color. Although laser treatment is effective in some cases, it is not widely used
Benign pigmented lesions
Benign pigmented lesions and melanocytic nevi (moles) are common benign pigmented lesions in children and adults. Benign pigmented lesions consist of lentigines, cafe-au-lait spots (coffee with milk spots), Beker's nevus, Mongolian spot, Ota and Ito nevi.
Lentigos are benign pigmented lesions that occur due to increased activity of epidermal melanocytes. Unlike freckles, which appear in fair-skinned children and disappear when they are not exposed to the sun, lentigines are permanent. There are two types of lentigos, simple lentigo and solar lentigo. Melanotic macules located in the mucosa are also examples of simple lentigo.
Simple lentigo:Simple lentigos are generally smaller than 5 mm in diameter, sharply demarcated, round-oval, brown or brown-black spots and appear in childhood. Typically there are few lesions and there is no tendency to favor sun-exposed areas. When there are many, different syndromes should come to mind.
Mucosal melanotic macule: Mucosal melanotic macules are frequently observed in young women and are mostly located at the vermillion border of the lower lip. Apart from this, it can also be observed in the oral mucosa and genital mucosa. When their numbers are high, Peutz-Jeghers and Laugier-Hunziker syndromes should come to mind. Multiple genital melanotic macules are part of Bannayan-Riley-Ruvalcaba syndrome.
Solar lentigo — Unlike simple lentigines, solar lentigines appear in sun-exposed areas such as the face, outer skin of the hands, forearms and upper body. Since the incidence of solar lentigines increases with age, they occur more frequently in older patients. It can also be observed in fair-skinned children after excessive sun exposure.
CAFÉ-AU-LAIT MACULES (coffee stains) are flat, light brown macules that appear at birth or in early childhood. While it can accompany some genetic syndromes, it can also be found alone in 25-30% of cases. Their sizes can vary from a few mm to 15 cm. As the child grows, these spots tend to expand.
BECKER NEVUS — It usually occurs during adolescence.
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