E-ISSN:2456-3110

Review Article

Melasma Etiopathogenesis

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 9 SEPTEMBER
Publisherwww.maharshicharaka.in

The Updated Review on Ayurvedic Melasma Etiopathogenesis

Iche K1*, Mane P2, Joshi V3
DOI:10.21760/jaims.9.9.22

1* Kalyani Iche, Post Graduate Scholar, Department of Roganidan, Dr DY Patil College of Ayurved and Research Centre, Pimpri, Maharashtra, India.

2 Prakash Mane, Professor and Guide, Department of Roganidan, Dr DY Patil College of Ayurved and Research Centre, Pimpri, Maharashtra, India.

3 Vinayak Joshi, HOD, Department of Roganidan, Dr DY Patil College of Ayurved and Research Centre, Pimpri, Maharashtra, India.

Since skin covers the entire body, it is a prominent bodily feature that is readily visible and appreciated. Self-esteem is greatly impacted by one's physical appearance, which also helps to create social connections and opens doors. Even while we claim that this is not a major medical problem, there is still plenty here to undermine one's self-assurance. Due to intense competition and globalization, being well-groomed has become essential for success. In Ayurveda, Vyanga (also known as Melasma) is stated under Rakta Pradoshaja Vyadhi and Kshudra Roga. This is an effort to describe the pathophysiology, symptoms, and causation of Vyanga. With careful examination and compilation of evidence from many Samhitas and contemporary literature, we can determine the precise etiopathogenesis of Melasma (Vyanga) from an Ayurvedic perspective.[1]

Keywords: Raktadushti, Ayurveda, Melasma, Vyanga, Kshudrarog

Corresponding Author How to Cite this Article To Browse
Kalyani Iche, Post Graduate Scholar, Department of Roganidan, Dr DY Patil College of Ayurved and Research Centre, Pimpri, Maharashtra, India.
Email: 		Iche K, Mane P, Joshi V, The Updated Review on Ayurvedic Melasma Etiopathogenesis. J Ayu Int Med Sci. 2024;9(9):154-157.
Available From
https://jaims.in/jaims/article/view/3373

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-08-08 2024-08-19 2024-08-30 2024-09-10 2024-09-19
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 11.21

© 2024by Iche K, Mane P, Joshi Vand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Being kind to one's skin is essential because it will be worn every day for the rest of one's life. Healthy skin is not a luxury. The largest organ in our body is the skin. The first line of defense against the outside world is the skin. It provides information on general health.[2] Numerous social and psychological research have shown how crucial face and bodily consonance is to our social interactions. People who are attractive are more likely to be successful in both their personal and professional lives, and this is linked to wellbeing. Self-esteem is greatly impacted by one's physical appearance, which also helps to create social connections and opens doors.[3]

Melasma was more common in women than in men, with a ratio of about 4:1. Melasma is a skin ailment that causes a face patch that is extremely pigmented. Melasma is a frequently occurring acquired disorder characterized by symmetrical reticulated hyperpigmentation patches on the face.[4] It is more common in women and people with darker skin types. The pathophysiology of this illness has been linked to a number of etiological factors, including sun exposure, hormonal impacts, hereditary factors, medications like phenytoin, and cosmetics. It is possible to treat melasma effectively with a variety of topical, oral, and procedural medications. Middle-aged women of various racial backgrounds frequently suffer from melasma, or hypermelanosis of the face, particularly if they have dark complexion.[5] Its exact etiopathogenesis is unknown, however potential causes include genetics, solar exposure, pregnancy, oral contraceptives, estrogen-progesterone therapy, thyroid disorders, and more.[6]

It is characterized by the appearance of Shyava Varna Mandalas (bluish-black patches) and niruja (painless) on the face, which are caused by the vitiation of Pitta and Vata Doshas, which are followed by Rakta Dushti. Tanu is thin. Texts from the Ayurvedic field, including Ashtanga Hridaya, Yoga Rantanakara, Sushruta Samhita, and Chakradutta, have discussed the causes and remedies for Vyanga. This article provides a comprehensive analysis and synthesis of contemporary literature and Ayurvedic texts pertaining to Panchanidana of Vyanga w.s.r. to Melasma. [7,8]

Aim and Objectives

1. To look up and reassess the Vyanga in different Ayurvedic texts, paying particular attention to Melasma.
2. To assess and clarify the pathophysiology and etiology of Vyanga.
3. To go into further detail and talk about Vyanga s.r. to management of melasma.[9]

Literature Review[10]

The Pancha Nidan of Vyanga as per Ayurveda and contemporary science Melasma, chloasma, pimples, and pigmentation can be caused by a variety of circumstances; whether it is a minor or severe type, it is typically linked to one or more of the following:

  • Pregnancy: Following delivery, the pigment may or may not diminish. Hormonal contraceptives, such as progesterone injections and oral contraceptive pills. Moreover, exposure to the sun is a significant risk factor.
  • Toiletries, cosmetics, and scented or deodorant soaps can result in a phototoxic reaction. Poor immune system.
  • The influence of genetic variables.
  • A lack of nutrients. Thyroid or ovarian problems. Pressure.[11]

There are instances where the cause is unknown. Sushruta and Vaghbhat state that doing Sthansanshray on the face might result in Vyanga and that working too much and getting angry can enhance Vata and Pitta Dosha. The aforementioned causative causes also result in an increase in Pitta and Vata.[12]

The literature of Ayurveda provides a disorganized yet comprehensive account of maintaining healthy skin. The core of Ayurvedic skincare is the appropriate use of Panchakarma (a bio-cleansing regimen), Rasayana (rejuvenation therapy), and Pathya Ahar-Vihar (a diet and lifestyle regimen), together with local applications like Abhyanga (massage) and Lepa (topical application of medicinal paste). The collection and analysis of Ayurvedic perspectives on skincare within the framework of modern science is the main objective of this essay. It would facilitate a deeper comprehension of the methods that are discussed and modern, efficient skincare practices.[13,14]


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Discussion

Melasma types based on Wood's (ultraviolet) light inspection, which reveals the depth of the pigmentation, there are four categories of melasma of chloasma, blemishes, or pigmentation:

  • Epidermal: The most prevalent kind has intensified color difference between unaffected and afflicted skin.
  • Dermal: Does not exhibit improved color contrast between unaffected and afflicted skin.
  • Mixed Epidermal and Dermal: Indicates an improvement in the color contrast in some affected areas of the skin but not in others.
  • In apparent: Affected lesions are not visible in Wood's light for individuals with very dark skin.[15,16,17]

Samprapti
According to Acharyas, Pitta Dosha and Prakupit Vayu, which are brought on by hard effort and wrath, suddenly appear in the face region and cause thin, blackish (Tanu) patches on the skin. The main causes are excessive labor and rage. Samprapti Pitta, Dosha-Vata, Ghataka. Rasa, Dushya-Rakta. Twaka Adhishthana-Mukhagat Vyadhimarga-Bahya Sadhyasadhyatva-Sadhya, Raktavaha Srotodushtikar-Sang Srotas-Rasavaha.[18,19]

Factors Aetiologic

↓

Pitta and Vata Dosha vitiation

↓

Rasa Dhatu Dushti

↓

Rakta Dhatu Dushiti

↓

Samurchita Dosha-Dushya formation on the skin of facial area

↓

Melasma (Vyanga)

Samprapti Ghataka

1. Dosha: Pitta and Vata
2. Dushya: Rasa and Rakta

3. Srotas: Rasavaha and Raktavaha Srotas
4. Mala: Twak Sneha
5. Srotodusti: Vimargagamana, Atipravrutti
6. Ama: Dhatvagnimandyajanya
7. Vyaktasthana: Twak (Mukha)
8. Udbhavasthana: Amashaya
9. Marga: Rogamarga Bahya

Melasma is classified according to the depth of melanin pigments:

1. Epidermal Melasma is found on the skin's outermost layers of cells. It has a light brown hue.
2. Dermal Melasma, which appears gray, develops between the epidermis and subcutaneous layer.
3. Complementary Dark brown melasma is seen between the epidermis and dermis. 1. Centrofacial melasma pattern: 63% on cheeks, forehead, upper lip, nose, and chin 2. Malar: 21% on nose and cheeks. 3. Mandibular: 16% on jawline and ramous of mandible.[20]

Diagnostic methods

1. Wood's light: Wood's light bulb emits ultraviolet light with a wavelength peaking at 360 nm.
2. Examining patches: This is a crucial and useful tool for the identification of contact-related allergic dermatitis.
3. Skin biopsy: A biopsy is performed to diagnose and evaluate skin illnesses, as well as to determine the type of lesions that are enlarging or inflamed.[21]

Ayurveda for managing Vyanga

1. Nidanaparivarjana or avoiding Hetu Sevan.
2. Shodhan Chikitsa: 1. Siravedha - 2. Abhyanga: 3. Kasisadi Ghrita, Sarshap Oil, Manjishthadi Sneha, and Mahamanjishthadi Tail.
3. Nasya - Manjishthadi Sneha, Brungaraj Swaraya.[22]

Description of the MELASQOL Scale

Since melasma mostly affects the mind rather than the body, a measure of quality of life has been established. The subject scores how concerned they are about on a scale from 1 (not worried at all) to 7 (bothered all the time).

1. How your skin condition looks.
2. Anger at the state of your skin.
3. Feeling self-conscious about your skin type.
4. Experiencing depression due to your skin type.


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5. How your skin condition affects how you interact with other people.
6. How your skin condition affects your urge to socialize.
7. A skin problem that makes expressing affection difficult.
8. Skin discoloration that makes you feel unappealing to other people.
9. Discoloration of the skin that makes you feels less important or effective.
10. Skin darkening that reduces your feeling of independence. Scores range from 7 to70, where a higher number denotes a worse quality of life connected to health issues related to melasma.[23]

Conclusion

A prevalent disorder that impacts a majority of the population is Vyanga. Although it is not a fatal illness, it destroys a person's self-esteem. Through a careful examination of collected material from many Samhitas and contemporary literature, we can determine the precise cause of Vyanga as per Ayurveda. Melasma formation is caused by a number of causes, including heredity, UV exposure, female sex hormones, and some cosmetic products; nonetheless, the correct etiology needs to be identified. Melasma typically affects people in the reproductive age range, primarily women. It can impair self-esteem and cause an inferiority complex since it causes a brownish-black patch to remain on the face, which deteriorates the skin's quality and appearance over time. Therefore, it is important to properly examine and analyze the causal cause.[24]

References

1. S N, Nateshan P, Soman D. Traditional Food for Dermal Health-A Review. AAM. 2022; 11(3): 256-269.
2. Shastri A. Sushrut Samhita of Acharya Sushrut. 1st Varanasi; Chaukhamba Sanskrit Sansthan; 2017. 320p.
3. Garde G. Sarth Vagbhat. 1st Varanasi; Chaukhamba Surbharti Prakashan; 2020. 7p.
4. Mishra S. Bhaishajyaratnawali, Varanasi; Chaukhamba Surbharti Prakashan; 2005. 936 -944p.
5. Garde G. Sarth Vagbhat. 1st Varanasi; Chaukhamba Surbharti Prakashan; 2020.69p.
6. Garde G. Sarth Vagbhat. 1st edition. Varanasi; Chaukhamba Surbharti Prakashan; 2020. 8p.


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