Melasma is prevalent across many racial groups.(Clinical Rounds)(Clinical report)

PARK CITY, UTAH -- Melasma is a chronic, relapsing condition occurring across racial groups, Dr. Susan C. Taylor said at a clinical dermatology seminar sponsored by Medicis.

Although the pigmentation disorder is seen primarily as a complication of pregnancy, Dr. Taylor said her literature review found 17 studies that reported on duration of melasma before patients were enrolled.

The median duration ranged from 2.8 years for patients in India to 12 years for whites and blacks, according to Dr. Taylor, director of the Skin of Color Center at St. Luke's-Roosevelt Hospital, New York. The studies also reported long median histories of melasma in Chinese (4.6 years), Korean (8 years), other Asian (10-12 years), and Puerto Rican (8-11 years) patients.

"Make sure the patient knows it is a chronic disorder," Dr. Taylor advised. "There is treatment, but it is very important to wear sunscreen."

Melasma is primarily a disease of women, with just about 5% of cases observed in men, she said. It is common in pregnancy, occurring in 50%-70% of pregnancies in the United States, usually in the second or third trimester. Hispanic women seem to be especially vulnerable, she said. In Mexico, she reported more than 80% of pregnant women experience melasma.

She also cited a recent telephone survey of 500 women with Spanish surnames in the Dallas-Fort Worth area. At the time of the phone calls, 7% of the women had melasma, she said. Among the women who did not report the condition to be current, 15% had a history of melasma.

Reports from medical practices in a variety of countries also show varying epidemiology, according to Dr. Taylor. She quoted proportions of patients with melasma ranging from 1.5% in Ethiopia to 39% in Thailand.