A Simple Guide to Chloasma, Diagnosis, Treatment and Related Conditions
By Kenneth Kee
()
About this ebook
This book describes Chloasma, Diagnosis and Treatment and Related Diseases
I had a clinic assistant who had 2 pregnancies 25 years ago.
With each pregnancy she develops large patches of chloasma all over her face.
She had tried bleaching agents, de-pigmentation products, chemical peels, cosmetic products without any success.
In fact the pigmentation becomes worse.
She finally resorted to skin specialist at the National skin Center to have her pigments removed by laser treatment.
After hearing the horror stories of some patients having bleeding followed by scarring of the face, she changed her mind and did not try the laser treatment.
To this day her face is still full of chloasma but she had grown used to it.
Chloasma also termed melasma or mask of pregnancy is a medical disorder featured by symmetrical dark patches with irregular borders on the face.
Chloasma is patches of dark skin that happen on parts of the face or neck that are exposed to the sun.
Chloasma is a frequent pigmentary skin disorder that can happen at any time in life.
It is simply a type of skin discoloration present on parts of the face in 30% of women of child bearing age.
Its start is normally linked to pregnancy or use of hormonal contraceptives combined with skin exposure to sunlight
The sunlight also acts like a trigger.
The disorder happens mainly in women but can also involve men.
While mostly a cosmetic disorder, it can be psychologically distressing to affected persons and can negatively affect self esteem.
Studies have indicated that people with darker or Asian skin tones have a higher possibility of forming the disorder.
Chloasma may have been there for a number of years and can be prevented or treated in many ways.
There are three sub-types of chloasma.
It could be classified according to the depth of the pigments:
1. Epidermal (brown),
2. Dermal (blue-grey),
3. A mixture of both (brown-grey).
It can also be classified into 3 types based on the distribution pattern of the pigments:
1. Centrofacial
2. Malar
3. Mandibular
Diagnosis is made mainly on medical features and a skin biopsy is not necessary.
1. Sun exposure is also a very strong triggering factor.
2. It is often linked with the female hormone estrogen and progesterone in:
a. Pregnant women,
b. Women taking oral contraceptives
c. Hormone replacement therapy (HRT) during the menopause.
3. Hormonal imbalances in the body can also trigger Chloasma
4. Visible Light (VL) all types such as UVA, fluorescent and even computer screens can spark the start of this type of disorder.
Recent studies have shown that VL may aggravate Chloasma through opsin S which is a specific sensor in melanocytes responsible for hyper-pigmentation.
5. Poor immune system - e.g., thyroid auto-immunity
6. Genetic factors – genetically predisposed persons are prone to developing chloasma on sun exposure
7. Medicines - Certain medicines and essential oils e e.g. sulfa drugs, tetracycline, NSAIDs, perfumed soap
8. Nutritional deficiency – zinc deficiency
Wood's lamp may assist to help the diagnosis
Wood’s lamp examination is useful finding the level of pigment deposition in all patients.
Epidermal chloasma is visualized clearly with Wood’s lamp examination.
Dermal chloasma is seen less clearly.
Present treatments are:
Chemical peels or topical steroid creams
Laser and light treatment
Micro-needling device that destroy dermal blood vessels
Intralesional or oral tranexamic acid
Avoid sunlight
TABLE OF CONTENT
Introduction
Chapter 1 Chloasma
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Freckles
Chapter 8 Hyperpigmentation
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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A Simple Guide to Chloasma, Diagnosis, Treatment and Related Conditions - Kenneth Kee
A
Simple
Guide
To
Chloasma,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2021 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes Chloasma, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.
(What You Need to Treat Chloasma)
This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank you for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.
This autobiography account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Disorders
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 800 eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical disorders.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
My diagnosis and treatment capability has improved tremendously from my continued education.
Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
Chloasma
I had a clinic assistant who had 2 pregnancies 25 years ago.
With each pregnancy she develops large patches of chloasma all over her face.
She had tried bleaching agents, de-pigmentation products, chemical peels, cosmetic products without any success.
In fact the pigmentation becomes worse.
She finally resorted to skin specialist at the National skin Center to have her pigments removed by laser treatment.
After hearing the horror stories of some patients having bleeding followed by scarring of the face, she changed her mind and did not try the laser treatment.
To this day her face is still full of chloasma but she had grown used to it.
What is Chloasma?
Chloasma also termed melasma or mask of pregnancy is a medical disorder featured by symmetrical dark patches with irregular borders on the face.
Chloasma is patches of dark skin that happen on parts of the face or neck that are exposed to the sun.
Chloasma is a frequent pigmentary skin disorder that can happen at any time in life.
It is simply a type of skin discoloration present on parts of the face in 30% of women of child bearing age.
Its start is normally linked to pregnancy or use of hormonal contraceptives combined with skin exposure to sunlight
The sunlight also acts like a trigger.
The disorder happens