Melasma Risk Factor and Management : A Review Article
Authors: Gofur Nanda Rachmad Putra 
Published: July 2024

Melanin granules are basically inside the keratinocytes, melanin granules will collect in the supranuclear area of ​​the cytoplasm so that the nucleus will be protected from the effects of damaging solar radiation. Although melanocytes form melanin, but those that function as a depot and contain more melanin pigment than melanocytes are epithelial cells. In keratinocytes, the melanin granules are fused with lysosomes. This is why melanin disappears in the upper cells. In the interaction process between keratinocytes and melanocytes, which results in skin pigmentation, the most important factors are the speed of melanin granule formation in melanocytes, transfer of granules into keratinocytes, and the final disposition of granules by keratinocytes. Human skin color is determined by various pigments. Those that play a role in determining skin color are carotene, melanin, oxyhemoglobin and reduced forms of hemoglobin, the most important of which is the pigment melanin. Melanosis is a disorder in the process of forming the skin's melanin pigment. First is hypermelanosis (melanoderma) when the production of the pigment melanin increases, can be caused by increased melanocyte cells or only increased melanin pigment. Conversely, leukoderma can be caused by a reduction in the amount of melanin pigment or a decrease or absence of melanocyte cells. Hypermelanosis of both types can result from three factors: genetic, hormonal (as in Addison's disease), when it is caused by increased circulating pituitary melanotropic hormone, and UVR. Aims of this article is to review melasma, clinical manifestation and management. Discussion : Melasma is acquired hypermelanosis that is generally symmetrical in the form of a light brown to dark brown patch of macules, affecting areas exposed to ultraviolet light with predilection sites on the cheeks, forehead, upper lip, nose and chin. Melasma can affect all races, especially people living in tropical areas. Melasma is mainly found in women, although it is also found in men (10%). In Indonesia, the ratio of cases of women and men is 24: 1. This is especially evident in women of childbearing age with a history of direct sun exposure. Most incidence is at the age of 30-44 years.Melasma treatment requires a long time, regular control and good cooperation between the patient and the doctor who handles the case. Most of these patients seek cosmetic reasons. Treatment and skin care must be carried out regularly and because melasma is chronic residual disease. Principle of treatment is a causal treatment, so it is important to find the etiology. Prevention against the onset or gaining weight and recurrence of melasma is protection against sunlight. Patients are required to avoid direct exposure to ultraviolet rays, especially between 09.00 and 15.00. preferably if you leave the house using a wide umbrella or hat. Conclusion : Risk factor of melasma is women with a history of direct sun exposure. Melasma lesions are defined light brown or dark brown macules with irregular edges, often on the cheeks, and nose, known as a malar pattern. Melasma treatment requires a long time, regular control and good cooperation between the patient and the doctor who handles the case. Principle of treatment is a causal treatment, so it is important to find the etiology.