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Q I have had all kinds of trouble with my skin for as long as I can remember. During my teen years, I had to deal with a terrible case of acne that made me the object of jokes at school. When I got older, my skin became very dry. Now that I'm pregnant, my skin has become spotty in places. What could this be? D.L., Atlanta

A Based on the way that you have described your problem, it appears that you could be experiencing a condition called melasma, which seems to be associated with pregnancy, oral contraceptives, sun exposure and a select group of anti-epilepsy drugs.

Doctors say melasma usually appears on the face (primarily on the forehead, cheeks, temples and jaws) as a group of dark brown patches. It is most common among women of child-bearing age, but a small percentage of men also are affected by the condition.

While the majority of cases appear to be related to pregnancy or oral contraceptives, endocrine dysfunction, genetic factors, medications, nutritional defiency and hepatic dysfunction also contribute to the skin condition. It is not, doctors say, considered to be a hereditary condition.

Sun exposure appears to be a stimulating factor in predisposed individuals, and sunscreen is considered the most important factor for successful treatment, which includes application of topical hypopigmenting agents.

# posted by Medical Information : 6:22 AM