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Melasma – Most common hyperpigmentation disorder. Melasma is a commonly known skin disorder of faulty pigmentation which manifests itself by symmetrical macular pigmentation of sun-exposed areas like the face. Areas where Melasma presents itself are, on the centrofacial region, malar cheeks, mandible, and rarely upper chest and extremities. It is more prevalent in females and darker skin types. It could be triggered by several factors, including pregnancy, birth control pills, hormone replacement therapy (HRT and progesterone), family history of melasma, race, and anti-seizure medications. Sunlight is considered the most important factor in the production of melasma, especially in individuals with a genetic predisposition to this condition.

How does melasma occur:
Various pathogeneses have been studied in melasma such as genetic factor(s), UV irradiation, or hormones in melasma. Some of these mechanisms are: -

  • Altered skin pigmentation, such as UV-induced pigmentation
  • Increased keratinocyte-derived melanogenic factors and their receptors
  • Increased expression of female sex hormone receptors and the identification of the PDZ domain containing 1 (PDZK1) signalling mechanism
  • The keratinocyte-derived paracrine factors, such as the stem cell factor (SCF) and Wnt inhibitory factor-1 (WIF-1)
  • The involvement of ion exchangers and microRNAs (miRNAs), such as H19 miRNA (miR-675) could also result in melasma

Treatment options for melasma include: Hydroquinone- Hydroquinone works by lightening the colour of the skin patches. Corticosteroids and tretinoin- come in creams, lotions, or gels. Both corticosteroids and tretinoin can help lighten the colour of the melasma patches. Combined creams -In some cases, a dermatologist may choose to prescribe combination creams that may contain hydroquinone, corticosteroids, and tretinoin in one. These are called triple creams. Additional topical medications- a dermatologist may also prescribe azelaic acid or kojic acid. These acids work to lighten the dark areas of skin. Newer approaches are as follows -

Kojic Acid - A natural metabolite produced by fungi that can inhibit tyrosinase activity in synthesis melanin. Licorice - Improves by dispersing the melanin, inhibition of melanin biosynthesis and inhibition of cyclooxygenase activity thereby decreasing free radical production. Glabridin, a polyphenolic flavonoid is the main component of liquorice extract.

p-Tero white – Is a natural ingredient that eliminates localized hyper-pigmentation, brightens skin, and works as an anti-oxidant, free radical scavenger, and anti-inflammatory when used at 0.1% to 0.5% in water based or emulsified products for the skin.

Nano Bright - It has extremely powerful anti-tyrosinase activity, hence, can be used for skin colour fading and to treat age spots, freckles, hyper pigmentation, and skin discoloration.

A dermatologist may also recommend procedures such as microdermabrasion, chemical peel, laser treatment, light therapy, dermabrasion.

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