Pregnancy, a special state of euphoria and happiness for most women, leading to a series of changes in the body. As the “belly” grows, dark spots may appear on the skin of the face: the chloasma.

What is chloasma ?

The chloasma or melasma, is included in the condition called discromías, which manifest irregularities in the color of the skin. According to Keys to the clinical diagnosis in Dermatology, Professor Jose Maria Mascaró, professor of the Faculty of Medicine, Barcelona, Spain, the determinants of color pigment in the skin are: hemoglobin and melanin.

The first element is present in red blood cells and is responsible for the degree of pallor or rubicundez the tegument. Melanin is what gives the very tone of the skin. Their presence varies according to ethnic groups, areas of the body and exposure to sunlight. This substance is produced by melanocytes at the level of the epidermis, the outer layer of skin. Melanocytes are cells with extensions like tentacles, which are interspersed among the structural cells of the epidermis, the keratinocytes. Thanks to these tentacles, melanocytes inject melanin in the upper part of the nucleus of keratinocytes.

Protective mechanism

Prepared as a cap, melanin acts in a way that protects the cell nucleus of the action of sunlight and prevents damage to the genetic material DNA in it. Thus, the production of melanin is a protective mechanism in the skin to reduce the deleterious effects of ultraviolet rays from the sun.

At certain times, and processes that do not yet have an accurate explanation, the skin can produce too much melanin. This is the case of chloasma.

The gravídico chloasma or the pregnancy is an entity within a more comprehensive, melasma. Chloasma and melasma are synonymous, and represent a hyperpigmentation of the skin in areas exposed to sunlight.

Melasma can have different causes, some are not known, idiopathic. But the most frequent pregnancy. And here it is lama chloasma gravidarum.

According to Fitzpatrick explains in his book Dermatology in General Medicine, the mechanisms that generate melasma or chloasma are unknown. While mentioning several causal factors, in addition to the pregnancy, the plot is not yet close elucidated. Among the other causes are involved oral diseases endocrinological-inclusive nature of ovarian cancer, cosmetics, medicines, hydantoin anticonvulsants, nutritional deficiencies, iron deficiency, protein and B vitamins, liver dysfunction, and genetic and racial factors.

However, it may be said that sunlight is the critical cofactor in the appearance of melasma or chloasma.

Chronology

Andalusia chloasma or melasma is called the mask of pregnancy because it manifests itself with varying degrees of brown spots, irregular skin on the cheeks, forehead, temples and peribucal region, remedando looks like a mask.

The problem is more common in women morenas. With regard to pregnant women, these spots may appear from the second month of pregnancy, and to widen as it progresses.

Along with the van also face the areolas hyperpigmented breast, the vulva, perianal region and around the anus, the scars and the white-abdominal stretching from the navel to the pubic.

But not necessarily all pregnant women suffer chloasma. A pregnant woman, genetically predisposed, to sun exposure are more likely to hiperpigmente, compared with a predisposed not pregnant.

By observing how frequently appears chloasma in pregnant women in one family, one can suspect that predisposition. But as the biology is not an exact science, the emergence of chloasma, its severity and recurrence in subsequent pregnancies, you can not specify.

Need treatment or be alone?

Chloasma usually due to pregnancy disappears shortly after birth. In those cases not associated with pregnancy, should investigate and correct the causes of hyperpigmentation, oral-suspension, the use of cosmetics aggressive statements addressing nutritional deficiency and liver diseases, among others.

But it will always be essential sun protection, according to skin type of each patient and prescribed by a dermatologist.

What happens when the chloasma persists? In this case we use a specific local treatment with medication, but may not always be effective.

It is necessary to determine where the pigment settles, if the more superficial layers of the skin or in the deepest. The more superficial they are best respond. There is a review, which is made with a special light, called Wood of light, which can detect, according to the experience of those who applied the method, if an employer has hyperpigmentation superficial, deep or mixed. And so we can estimate the value of treatment.

Among the drugs used historically depigmentantes or bleaching is hydroquinone. Applied locally at concentrations between 2 and 4 per cent, alone or in association with other chemicals, such as retinoic acid andalusia 0025 to 0.1 percent, and glycolic acid to 8 percent. These acids have an effect peeling, and help in the removal of pigment. In the market already made in cream, used for a period of between four and eight weeks, it gives good results but also has its drawbacks, can cause skin irritation in contact with them.

While the treatment of chloasma is done by the dermatologist, pregnant women can help in preventing it. To do so, it would be advisable to avoid direct sunlight, especially at peak light intensity. Thus, a good hat, sun screen to protect a whole … and to enjoy the pregnancy.

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