Clinical Profile of Male Melasma and Association of its Severity with Serum Testosterone

Abstract

Introduction 
Melasma is a common skin condition presenting with symmetric brown pigmentation on sun exposed areas, especially face. Most of the studies in melasma have been focused on females. Few studies in male melasma have revealed lower level of serum testosterone level. This study aimed to describe male melasma in terms of clinical presentation, severity, and relationship with serum testosterone levels. 
Methods
This was a descriptive study where cases of male melasma were assessed for clinical patterns and severity using modified melasma area severity index(mMASI). The association of severity of melasma with serum testosterone level was determined.
Results
Forty-two males with melasma were enrolled in the study. The age ranged from 20 years to 57 years, with a mean age of 32.7±7.5 years. Majority had Fitzpatrick’s skin type IV and malar pattern was predominant. Average time of sun exposure ranged from 30 minutes to 8 hours. mMASI score ranged from 2.40 to 14.90. Serum testosterone level was lower than the reference range in 14(33.3%) cases. However, multiple linear regression analysis showed that serum testosterone was not independently associated with melasma severity after adjusting for age (β=-0.339, p=0.028) and sun exposure in hours (β=0.442, p=0.008).
Conclusion
Male melasma was common Fitzpatrick type IV skin with predominant malar pattern. This study showed that serum testosterone was not associated with melasma severity in males after adjusting for age and duration of sun exposure.