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Melasma Significantly Impacts Quality of Life Among Patients With Darker Skin Types


Investigators also developed a MELASQoL model using 4 predictors of quality of life impacts in patients with melasma.

Alessandro Grandini/Adobe Stock
Alessandro Grandini/Adobe Stock

In a cross-sectional study conducted in Durban, South Africa, researchers examined the relationship between melasma and its impact on the quality of life (QoL) of affected individuals, particularly among patients with darker skin types.

Researchers enrolled patients older than 18 years with existing facial melasma, both male and female, encompassing Fitzpatrick skin types IV–VI. The study focused on Black and mixed ancestry individuals with all types of melasma (epidermal, dermal, or mixed facial). Vulnerable populations and minors were excluded from participation, as were those with lighter skin types and other hypermelanosis skin disorders.

The study enrolled 150 patients from an existing database. A questionnaire was administered either online or face-to-face. The data collection spanned from March to December 2022, involving clinical examinations and diagnoses by dermatologists.

The study's respondents, predominantly females (95%), had an average age of 47.30 years. Melasma distribution across facial regions, duration of the condition, triggers, and familial connections were documented. Researchers noted that 61% of participants had no family history of melasma.

Using the Melasma Severity Index (MASI) and the MELASQoL questionnaire, researchers gauged the severity of melasma and its impact on QoL, respectively. The MASI scores indicated an average severity of 40.62. The study employed stepwise regression analysis to predict MELASQoL scores using 28 independent variables. The analysis resulted in a final model (Model 4) incorporating 4 predictors: MASI, Cheeks, Education, and Menopausal. Model 4's predictors—MASI, Cheeks, Education, and Menopausal—were all statistically significant at the 0.05 level.

MELASQoL scores were relatively high, indicating a substantial impact on QoL. The relationship between MASI and MELASQoL scores was statistically correlated, emphasizing that even mild melasma can affect patients emotionally.

Additionally, researchers explored the use of sunscreen, genetic predisposition, aggravating factors, and product use among patients. Results showed that 89.33% of respondents used sunscreen, with affordability and skin reactions being key reasons for nonuse.

"In this study, we found that an impairment on the quality of life is greater irrespective of the underlying melasma conditions. Even when melasma is not severe, it can cause emotional stress, potentially reducing patients’ quality of life," wrote authors Mpofana et al. "It serves as a valuable test case for future research. The study concludes with suggestions for future research that compare the experiences of melasma in urban and rural settings, considering the differences in lifestyle behaviors that may affect treatment outcomes and ultimately enhance a patient’s quality of life."


Mpofana N, Paulse M, Gqaleni N, et al. The effect of melasma on the quality of life in people with darker skin types living in Durban, South Africa. Int J Environ Res Public Health. 2023;20(22):7068. Published 2023 Nov 16. doi:10.3390/ijerph20227068

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