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Chloasma faciei is condition of abnormally darkened skin that occurs mostly on the face of pregnant women. This condition is also known as melasma or the mask of pregnancy. However, chloasma faciei can also occur in women that are not pregnant and is always related to some form of hormonal imbalance, often a result of hormone replacement therapy or the use of birth control pills.

What Does Chloasma Faciei Look Like?

Chloasma faciei usually manifests as darkened areas located on your upper cheek, nose, lips, upper lip, and forehead. These hyperpigmented areas can look like discrete freckles or may appear as patches which may develop gradually over time. 

What Causes Chloasma Faciei?

Chloasma faciei is thought to result from the excessive stimulation of melanocytes (pigment-producing cells) under the influence of female sex hormones such as estrogen and progesterone. These hormone sensitive melanocytes will consequently lead to irregular skin coloration especially when these areas of skin are exposed to sunlight.

Chloasma faciei is most prevalent in women that have light brown skin and have been exposed to intense levels of sunlight. There is also some genetic predisposition to chloasma faciei.
Any condition that increases melanocyte stimulating hormone (MSH) can increase your risk of developing chloasma faciei.  MSH is produced in a specific part of your brain known as the pro-opio- melano-cortin receptor (POMC). Your POMC is influenced by thyroid disease, sun exposure, various forms of stress and adrenal disease.

A specific form of chloasma faciei known as Melasma Suprarenale can be a symptom of Addison’s disease (adrenal cortex failure) that results in excessive production of adrenal cortico tropic hormone (ACTH), which as affects your POMC.
It is likely that any form of excessive stress that leads to overstimulation of ACTH can contribute to the development of chloasma faciei.

Treatment of Chloasma Faciei

  • Identify and rectify any hormonal imbalances that are contributing to the problem in the first place – for example – cessation of birth control pills (synthetic, non bio-identical sex hormones) – cessation of inappropriately administered hormone replacement therapy (HRT) – improvement in adrenal function and adrenal stress and fatigue through the amelioration of factors that contribute to adrenal stress and fatigue (dietary, hormonal, immune system and nervous system therapies)
  • Avoidance of sun exposure and use of sun blocking agents
  • Use of topical depigmenting agents such as hydroquinone. Azelaic acid Tretinoin to increase the rate of fading of discolored skin patches.
  • Chemical peels – to remove the outermost layers of hyperpigmented skin
  • Microdermabrasion – to remove the outermost layers of hyperpigmented skin.

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