An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology
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53 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY February 2018 • Volume 11 • Number 2 R E V I E W M Melasma is a common skin condition characterized by the presence of symmetrical, irregular, light to dark brown hyperpigmentation involving sun-exposed areas, especially on the face. Although melasma can affect all races and both sexes, it is more commonly seen in women of child-bearing age and in dark- skinned individuals living in areas with intense ultraviolet (UV) radiation. 1,2 Hyperpigmentation on exposed areas such as the face can be a source of cosmetic concern for patients, that can negatively impact quality of life (QOL). Melasma in women has been studied in detail, but despite several similarities, there are certain differences in clinical, etiological, and treatment aspects of melasma in men that still need to be studied. Understanding characteristics of melasma specific to men will allow for better management of the disorder among male patients. This article aims to highlight the important clinical, etiological and treatment aspects of melasma in men. METHODS The information was collected through an extensive literature search from the databases Pubmed and Cochrane Library. The keywords used for the search were melasma, etiology and men. Articles published within the last 20 years were included. However, some older publications were included in order to describe the evolution of melasma in men. Poorly designed studies and those with conflicting results were excluded. Signed photoconsent was obtained from patients whose photographs are included herein. EPIDEMIOLOGY The exact prevalence of melasma is not known among the general population, including men and women. This could be due to underreporting by the affected patients due to its asymptomatic nature and because many patients choose to treat it with over-the-counter products rather than consult with a dermatologist. 3 The global prevalence of melasma varies according to ethnicity, skin type, and intensity of sun exposure. It has been found to be more common in Hispanics, Asians, and African Americans than in Caucasian populations. 1,4 Further, it is more common in individuals with dark skin and Fitzpatrick skin types IV, V and VI. 5,6 The majority of the studies reporting the prevalence of melasma are based on clinical samples rather than population samples. The prevalence of melasma among the general population is reported to be 1.8 percent in Ethiopia 7 , 2.88 percent in Saudi Arabia 8 , 3.4 percent in Lebanon 9 and 8.2 percent in United States. 10 South Asian countries have a relatively higher prevalence of melasma than in other countries, as seen in Nepal (6.8%) and China (13.61% ). 11,12 Research has shown that melasma is more common in women than in men. Studies in A B S T R A C T Melasma is a common skin condition that affects both men and women. However, it is more commonly seen in women and dark-skinned individuals, such as in Hispanics, Asians, and African Americans who live in areas with intense ultraviolet radiation. Melasma is less common in men, but it negatively affects the quality of life in men as much as it does in women. While melasma has been studied in detail in women, however, there is a paucity of studies on the clinico- etiopathology and therapeutics of melasma in men. This article reviews and discusses important clinical, etiological, and treatment aspects of melasma in men. The authors recommend that clinicians educate their patients on the causes, prevention and treatment methods, and recurrence rates of melasma. The authors also recommend that clinicians take into careful consideration each patient's preferences and expectations when creating treatment regimens, as these might differ greatly among men and their female counterparts. Melasma in Men: A Review of Clinical, Etiological, and Management Issues by RASHMI SARKAR, MD, MNAMS; PALLAVI AILAWADI, MD, DNB; and SHILPA GARG, DNB Dr. Sarkar is a professor at the Department of Dermatology, Maulana Azad Medical College in New Delhi, India. Dr. Ailawadi is Senior Resident at the Maulana Azad Medical College and LokNayak Hospital in New Delhi, India. Dr Garg is Consultant Dermatologist, Sir Gangaram Hospital in New Delhi, India. J Clin Aesthet Dermatol. 2018;11(2):53–59 FUNDING: No funding was provided for this article. DISCLOSURES: The authors have no conflicts of interest to relevant to the content of this article. CORRESPONDENCE: Rashmi Sarkar, MD, MNAMS; Email: rashmisarkar@gmail.com