Old causative factors with an overestimated
role?
A large survey performed in 324 patients from 12 centres of nine
countries has been conducted to better understand the UV radiation and hormonal influences in the development of melasma.1
Almost half of the patients had a familial history of melasma. Melasma affects most patients in the 3rd or the 4th decade of life, but
onset of the lesions after 40, or 50 year-old is observed in 14%
and 6% of cases respectively. The onset of the disease is found to
be earlier in light skin types, whereas dark skin types (V and VI)
are usually associated with a late onset of melasma (even postmenopausal). Only 20% of melasma occurred in the peripregnancy period. The risk of onset during pregnancy was associated with having spent more time outdoors. Interestingly, the contraceptive pills appear to have a weak impact on the evolution of
melasma. Moreover, the impact of the hormonal treatment is even