Effectiveness of a Broad-Spectrum Sunscreen in the Prevention of Melasma in Asian Pregnant Women
6
Table 2. Facial cleansing and skincare routine.
Products N of patients (%) (N = 217)
Cleansing
Make-up remover 9 (4%)
Cleansing product
(foaming cream, gel, bar soap…) 215 (99%)
Lotion or cosmetic water 216 (100%)
Skincare
Essence/serum 207 (96%)
Milky lotion or fluid 215 (99%)
Cream (without photoprotection) 208 (96%)
Usual daily photoprotection 189 (87%)
Table 3. Characteristics of the 3 affected women.
No. 1 No. 2 No. 3
MASI 2.1 2.7 1.2
MASI forehead 0 0 0
MASI chin 0 0 0
MASI right malar 0.9 1.8 0.6
MASI left malar 1.2 0.9 0.6
Melanin index
Non-pigmented right malar 149 145 129
Pigmented right malar 155 176 144
%* +4% +21% +11%
Non-pigmented left malar 133 151 132
Pigmented left malar 178 154 175
%* +34% +2% +32%
Quantity of products used (g) 205 165 155
%* = (pigmented area value − non-pigmented area value)/non-pigmented
area value × 100.
grade melasma were noted out of the 217 parturients who
completed the study, corresponding to 1%. This occur-
rence is much lower than the 2.7% we saw in the Mo-
roccan study [7] or than that in usual conditions in the
same geographical area [4]. Even if there are no pub-
lished data on prevalence melasma in Korea, according
to data obtained in 2001 (unpublished data) dealing with
normal Korean female population, the prevalence rate of
the perinatal and premenopausal women with melasma
showed 38% and 23% respectively.
Nevertheless, this study was not a comparative study
and it is important to note that it was limited by the lack
of a control group without sunscreen usage.
The Statistical Yearbook of Korean National Survey in
2010 says that the average age of women giving their
first baby is 30.1 years. In this study, the average age of
group was younger (27 years) and more than 80% are
women having their first baby. These young pregnant
women may have a lower risk of developing melasma.
Furthermore, the gestation stage of study group is usually
earlier than late stage. The later the gestation stage is, the
more melasma cases would be recruited. All these may
explain the very low occurrence rate noticed in this
study.
Nevertheless, we would advise dermatologists and
gynecologists as well as general practitioners to recom-
mend a safe and effective broad-spectrum sunscreen,
associated with an appropriate skincare routine as part of
their pregnancy follow-up. This would avoid difficult
post-pregnancy treatment of melasma. The safety and
high-grade cosmetic properties of the sunscreen product
adapted to the Asian skincare routine to improve pa-
tients’ compliance are also important.
5. Acknowledgements
We thank Amy Whereat who provided editorial support,
Martine Fortuné, Guénaëlle Le Dantec and Bernard Gab-
ard for their administrative support and Stéphanie Ragot
for the statistical analysis. The Leaders Clinic Derma-
tologists and the Kwak Gynecology clinic team are also
gratefully acknowledged.
REFERENCES
[1] M. Jimbow and K. Jimbow, “Pigmentary Disorders in
Oriental Skin,” Clinics in Dermatology, Vol. 7, No. 2, 1989,
pp. 11-27.
http://dx.doi.org/10.1016/0738-081X(89)90053-9
[2] J. H. Chung, “Photoaging in Asians,” Photodermatology,
Photoimmunology & Photomedicine, Vol. 19, No. 3, 2003,
pp. 109-121.
http://dx.doi.org/10.1034/j.1600-0781.2003.00027.x
[3] S. G. Ho and H. H Chan, “The Asian Dermatologic
Patient: Review of Common Pigmentary Disorders and
Cutaneous Diseases,” American Journal of Clinical Der-
matology, Vol. 10, No. 3, 2009, pp. 153-168.
http://dx.doi.org/10.2165/00128071-200910030-00002
[4] R. Wang, et al., “Prevalence of Melasma in Chinese Han
and Chinese Yi: A Survey in Liangshan Distric,” The
Chinese Journal of Dermatovenereology, Vol. 6, 2010, pp.
546-548.
[5] A. Taylor, M. Pawaskar, S. L. Taylor, R. Balkrishnan and
S. R. Feldman, “Prevalence of Pigmentary Disorders and
Their Impact on Quality of Life: A Prospective Cohort
Study,” Journal of Cosmetic Dermatology, Vol. 7, No. 3,
2008, pp. 164-168.
http://dx.doi.org/10.1111/j.1473-2165.2008.00384.x
[6] M. Perez, J. Luke and A. Rossi, “Melasma in Latin Ame-
ricans,” Journal of Drugs in Dermatology, Vol. 10, No. 5,
2011, pp. 517-523.
[7] H. Lakhdar, K. Zouhair, K. Khadir, A. Essari, A. Richard,
S. Seité and A. Rougier, “Evaluation of the Effectiveness
Open Access JCDSA