Melasma is a common disorder of acquired hyperpigmentation characterized by tan or brown macules and patches localized to photo-exposed areas of the face.

To study the psychological impact of melasma on Tunisian women.

We conducted a cross-sectional study on thirty patients with melasma who attended the dermatology department of the University Hospital in Sfax (Tunisia).

The questionnaire included socio-demographic and clinical data. We used four measurement scales:

– MELASQOL questionnaire;

– Rosenberg Self-Esteem Scale;

– Hospital Anxiety and Depression Scale;

– Body Image Questionnaire.

The mean age was 34.6 years. The majority was living in urban areas (90%), was married (56.7%) and had a profession (80%).

Sixty percent of patients were anxious and 16.7% were depressed. Both self-esteem and body image were respectively altered in 43.3% and 36.6%. The average score of MELASQOL was 31.77%. It was higher in single woman (36.8 vs. 28.4), younger than 40 years old (31.5 vs. 21.7), having a low socioeconomic status (45.2 vs. 29) and working in private sector (40 vs. 24).

The quality of life was more damaged in patients with disease duration less than five years (P = 0.024).

Anxious patients had higher MELASQOL scores than non-anxious (38.17 vs. 22.17; P = 0.008), as well as depressed patients (49 vs. 28.32; P = 0.009).

High MELASQOL scores were correlated with low self-esteem (P = 0.05) and altered body image (P = 0.04).

Although benign, melasma causes an important psychological impact such as anxiety, depression, low self-esteem and poor body image. These effects should be considered in the care plan.

The authors have not supplied their declaration of competing interest.