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.
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