Risk factors and severity of melasma in patients attending dermatology outpatient department of a tertiary care hospital: A cross-sectional study

Melasma is a chronic acquired dysfunction of melanogenesis characterized by dark brown irregular macules on skin. Genetic predisposition, pregnancy, sun exposure, and hormonal therapy are common risk factors. Prevalence of melasma is variable, ranging from 5% to 46%. This study aimed to assess the severity and potential risk factors of melasma in a tertiary care setting. An analytical cross-sectional study was conducted on patients with melasma visiting dermatology department of a tertiary care center in Nepal. Nonprobability consecutive sampling was adopted. Severity of melasma was assessed using the Modified Melasma Area and Severity Index score. Data analysis was performed using the Statistical Package for the Social Sciences, version-23. Bivariate analysis was done by using Student t test/Mann-Whitney U test, or Chi-square/Fischer exact test for continuous and categorical variables, respectively. The overall median Modified Melasma Area and Severity Index score was 5.40 (3.60-6.75). Most patients (168, 88.42%) had mild melasma. The severity score was significantly higher in older age (P = .024), women having parity more than 3 (P = .014), centrofacial pattern (P = .024), and patients having dermatological comorbidities (P = .014). Severity was significantly lower in those who used cosmetics at home. Moreover, the use of digital screens was not associated with an increase in melasma severity. Most of the cases had mild melasma. Severity was significantly associated with age, parity, pattern, practice of cosmetic use, and presence of dermatological comorbidities.