Objective and Subjective Measures of Melasma

Melasma is a cutaneous disorder involving the face and, less frequently, the neck and forearms, that is characterized by tan, brown, or gray-blue macules or patches. Variations in the clinical appearance of melasma are related to where the pigmentation occurs within the skin. In epidermal-type melasma, melanin is deposited in the basal and suprabasal layers, and a tan or brown color is observed. In contrast, in dermal-type melasma, melanin-containing macrophages are present in the superficial and deep dermis, and a gray-blue color is observed. In mixed-type melasma, melanin is present in both the epidermis and the dermis, and a brown, gray, or combination brown-gray color is observed.