A clinico-epidemiological study of melasma in a tertiary care hospital: A cross sectional study

Background Melasma is a common acquired facial melanosis seen predominantly in females. It is characterized by symmetric reticulate hyperpigmented macules on the face. It is a cosmetic problem which affects the social and emotional well being of patients especially females. The treatment is unsatisfying, lesions usually resistant and recurrent. Methods This was a cross sectional study conducted over a period of 1 year.  A total of 200 patients who were clinically diagnosed as melasma were enrolled in study. A detailed history regarding demographic details, past medical history, family history and various precipitating factors were taken. Severity of melasma was assessed by Melasma Area Severity Index (MASI) score. Data were analyzed using SPSS version 20. Descriptive statistical tools like mean and Standard Deviation (SD) were used for quantitative variables; frequency and percentage for categorical variables. A p value of < 0.05 was considered as statistically significant. Results Out of 200 patients, 167 patients were females and 33 patients were males with F: M ratio 5:1. Common age group affected was 41-50 years with a mean of 47 years. Majority were home makers. Significant family history was observed in 72% patients. 80% patients gave history of exacerbation with sun exposure. Exacerbation during pregnancy was noted in 31.1% and 66% patients gave stress as an exacerbating factor. 21% of patients gave history of hypothyroidism and 6% females gave history of Oral Contraceptive Pills (OCP) usage. 50.9% females were menopausal. Most common pattern observed was malar type. Statistical analysis revealed significant association between age and gender. Mean MASI was 4.6. Conclusion The exact etiopathogenesis of melasma is unknown. In this study most common exacerbating factor observed are sun exposure and family history. Other factors such as hormonal factors, stress, pregnancy and OCP usage was also found to be associated with melasma.