Melasma is a common acquired skin disorder that presents as bilateral, blotchy, brownish facial pigmentation.
This form of facial pigmentation was previously called chloasma, but as this derives from the Greek meaning ‘to become green’ the term melasma (brown skin) is preferred. It was also known as ‘mask of pregnancy’.
Melasma is more common in women than in men, with an onset typically between the ages of 20 and 40 years. Melasma is most common in people who tan easily or have naturally brown skin. It is less common in people with fair skin or black skin.
Melasma can have severe impact on quality of life due to its visibility.
Causes -
The cause of melasma is complex; it has been proposed to be a
· Photoageing disorder in genetically predisposed individuals
· Overproduction of melanin by melanocytes; either taken up by keratinocytes (epidermal melanosis) and/or deposited in the dermis (dermal melanosis, melanophages)
Factors implicated in the development of melasma include:
· Family history: 60% report affected family members.
· Sun exposure: Ultraviolet and visible light promote melanin production.
· Hormones: Pregnancy and the use of oestrogen/progesterone containing oral contraceptives, intrauterine device, implants, and hormone replacement therapy, are implicated in one-quarter of affected women; thyroid disorders can be associated with melasma.
· Medications and scented products: New targeted therapies for cancer and perfumed soaps, toiletries, and cosmetics may cause a phototoxic reaction to trigger melasma.
· Researchers are examining the roles of stem cell, neural cell, vascular, and local hormonal factors in promoting melanocyte activation.
Symptoms -
Brown colored patches of skin appear on the forehead, temples, cheeks or above the upper lip.
Melasma can be separated into epidermal, dermal, and mixed types, depending on the level of increased melanin in the skin.
Epidermal melasma: Epidermal melasma is defined by:
· Border: well, defined.
· Color: dark brown.
· Wood lamp: appears more obvious.
· Dermoscopy: Scattered islands of brown reticular network with dark fine granules.
· Treatment: Usually has a good response.
Dermal melasma: Dermal melasma is defined by:
· Border: Ill-defined.
· Color: Light brown to blue-grey.
· Wood lamp: No accentuation.
· Dermoscopy: Reticuloglobular pattern, telangiectasia, arciform structures.
· Treatment: Usually has a poor response.
Mixed melasma: Mixed melasma is the most common type, and is defined by:
· Combination of blue-grey, light and dark brown colors.
· Wood lamp: Mixed patterns.
· Dermatoscopy: Mixed patterns.
· Treatment: Usually shows a partial improvement.
HOMEOPATHY MEDICINES -
Homoeopathy today is a growing system and is being practiced all over the world. Its strength lies in its evident effectiveness as it takes a holistic approach towards the sick individual through promotion of inner balance at mental, emotional, spiritual and physical levels. When Melasma is concerned there are many effective medicines are available in Homoeopathy, but the selection depends upon the individuality of the patient, considering the mental and physical symptoms.
ARGENTUM NITRICUM :
Face looks sunken, old, pale and bluish. Old man’s look, sickly, sunken greyish of muddy color. Skin is brown, tense, and hard with irregular blotches.
CADMIUM SULPHURATUM :
Melasma with yellow stains on nose and cheeks. The color varies from yellowish to brown. The color gets worse from exposure to sun and wind. Itching of the face.
CAULOPHYLLUM THALICTROIDES :
Moth spots on forehead with leucorrhea. Discoloration of skin in women with menstrual and uterine disorders. Skin hot, and dry.
COPAIVA OFFICINALIS :
Brown spots on face. Presence of circumscribed lenticular patches with itching. Mottled appearance.
LYCOPODIUM CLAVATUM :
Grayish-yellow discoloration of the face, with blue circles around the eyes. Withered shrivelled copper colored eruption on face with melasma, especially in men. Flatulent abdomen. Likes warm food and drinks. Craving for sweets.
PLUMBUM METALLICUM :
Melasma with yellow, corpse like spots on sunken cheeks. Sunken cheeks. Skin of face is greasy and shiny. Face pale and emaciated.
PHOSPHORUS :
Melasma with circumscribed redness in one or both the cheeks with pale, sickly complexion. Burning heat and redness of cheek. Blue rings under the eyes. Hippocratic countenance. Craves cold, iced drinks, and chocolate.
SANGUINARIA CANADENSIS :
Circumscribed red spots over malar bones. Redness and burning of cheeks. Red blotchy eruptions, worse in spring.
SEPIA :
Saddle-like yellow discoloration on nose and cheeks. Dark circle under the eyes. Facial discoloration during pregnancy, after childbirth and menopause. Lentigo in young women.
SULPHUR :
Skin pigmentation after local medication. Old looking spotted face. Suited to dirty, filthy people prone to skin affections. Skin is unhealthy, dry, rough, and dirty. Itching, and burning sensation on the face, worse from heat.
THUJA OCCIDENTALIS :
Skin pale, waxy, shiny, and dark under the eyes. Nettled with spider like veins. Skin looks dirty, dry, hairy with brown spots.
M.G HOMEO CLINIC
Dr Dileep Yadav
