Hormonal Milieu in the Maintenance of Melasma in Fertile Women

Abstract Melasma is a specific type of facial hyperpigmentation seen in women taking oral contraceptives, in non‐pregnant women who have not used oral contraceptives, and in some pregnant women during the progression of gestation, but rarely in men. Circulating LH, FSH, PRL, and E 2‐ 17β on day 5, 7, 9, and 11 of the menstrual cycle and progesterone (P) on day 17, 19, and 21 were measured in thirty‐six ovulating women with melasma (study group) age 25–35 years and twelve healthy controls (control group). Twenty‐seven subjects in the study group had normal pregnancies; 9 others were married or single and had no history of contraceptive pill use. Higher levels of FSH on day 7 (p<0.05); E 2‐ 17β on 5, 7, 9 (p<0.05) and LH on day 9 (p<0.002) were observed in the study group than in the control group. There were no significant differences between the LH/FSH ratio in the two groups. Serum PRL was lower on day 9 in the study group (p<0.05) than in the control group. Serum P was similar in the patients and the controls. These findings indicate a possible role of high E 2‐ 17β in the maintenance of melasma.