Melasma is a wide-spread skin condition that affects all races and genders. While it occurs more often in women than in men, a recent literature review published in the Journal of Clinical and Aesthetic Dermatology suggests there are important differentiating factors clinicians should be aware of when treating melasma in men.
Researchers conducted a PubMed and Cochrane Library literature search using the keywords melasma, etiology and men, limiting the results to the past 20 years. There was the exception of including older publications necessary to describe the evolution of melasma in men. They excluded studies with poor design or conflicting results.
While the global prevalence of melasma is unknown, they found incidence varies by factors including ethnicity, skin type and sun exposure, confirming melasma is more common in people with Fitzpatrick skin types IV to VI and with Hispanic, Asian and African heritage.
For male melasma patients in particular, “It appears to affect dark-skinned men of Asian and African-American origin more frequently than previously thought,” they write.
Although melasma generally presents similarly in men and women, the authors note the malar clinical pattern for melasma is most common in men while the centrofacial pattern is more common in women.
Managing melasma in men requires medical treatment, the first-line treatment being topical therapy with triple combination cream.
“Monotherapies and dual therapies have lower efficacy, slower onset of action, and are recommended to patients unable to access triple therapy or who have sensitivity to the ingredients,” according to the authors.
Sarkar R, Ailawadi P, Garg S. Melasma in Men: A Review of Clinical, Etiological, and Management Issues. J Clin Aesthet Dermatol. 2018;11(2):53-59.