Melasma and its homoeopathic management

Dr Anupma Bhushan Mishra

Abstract
Melasma is the most commonly acquired by hyperpigmented disorder found mainly in women.

Nowadays, everyone is so much health conscious, especially for their physical appearance so they need treatment for every little thing appearing on their body.

In modern society- a fashionable world, people spend so much money for their beauty , specially female run towards beauty parlour.

Melasma mainly caused by harmful effects of U.V.rays, Cosmetics, hormones, pregnancy, genetics and some of the internal causes.

In O.P.D. we see so many cases of melasma. Homeopathic treatment is very well applied by following the individualistic approach.

Keyword
Hyperpigmentation chloasma , constitutional remedy.

Symptoms and etiology
Circumscribed patches are well defined,while diffuse are less so,but both may vary greatly in shape, size and colour.

They usually yellowish brown or fawn coloured but may be dark brown or black(melasma,melamoderma).The face is common location for circumscribed variety while axilla,genitals,nipples and other relatively deeply colored parts of skin are most effected in general form.there are no subjective symptoms or sensation.

Epidemiology
In a study conducted in India, an even greater discrepancy between men and women was identified: among 120 patients with melasma, 25.8% were men. In this study,  most of the countries are situated at intertropical latitudes.

Also in India, it was demonstrated that average age and disease duration were similar between men (33.5 and 3.5 years) and women (31.5 and 3.1 years). For women, risk factors were associated with pregnancy (45.3%), sun exposure (23.9%) and use of combined oral contraceptives (COC) (19.4%)

Etiology
It’s multifactorial, Cause unknown idiopathic form due to external cause such as ,long continued friction or pressure,excoriations, unusually repeated or prolonged,heat or cold(called cholasma caloricum) or x-ray.

Symptomatic
It is due to internal causes including pigmentation associated with diseases of spleen, liver, Suprarenal capsule, some diseases- tuberculosis, malaria, goitre, cancer, hepatitic cirrhosis, etc. 

In symptometic type extensive colour changes. Pigmentation maybe incidental to or follow lesion of syphilis, leprosy, lichen planus, senile atrophy, psoriasis. 

Pregnancy(chloasma uterinum)
A Common type of Ovarain and uterine disorder, it disappears after delivery, but persist in some cases. Particularly when it follows an abortion or miscarriage. In few cases it has followed the use of Contraceptive pills, while in others it has improved. Hormone replacement and menopause.

 Nutritional-diet deficient in animal fats, protein, vegetables fruits.

Cosmetics
Powder creams (local irritant)contain volatile oils,aniline dyes and perfumes may produce chloasma due to their photosensitizing action.

Pathology
It is a morbid process is an increase of normal pigmentation found in mucus layer of epidermis. Symptomatic nervous system no doubt plays a important role in pathological process because many cases of Chloasma are related to some diseases of hepatic and Gastro intestinal disorders and pigment function is  pigment function is apparently  controlled by nervous system.

Homoeopathy has safe and effective remedies for treating the melasma it helps by restoring and even tone to skin and controlling further progression of pigmentation diseases of skin are very important for physician to deal with coma hence the the need for special mention of of certain relevant and important points except in rare cases all skin disease come from within hahnemann consider it outwardly reflection of internal derangement of vital force therefore be treated by presentation of cases piInternational medicine from within a perfectly healthy body must poses perfectly healthy skin and Ada and a disease skin cannot possibly exist Upon A a perfectly healthy body does the treatment of skin diseases by outer application is a a serious and dangerous professional error 

Good nursing diet and regular exercise are helpful

Selection of specific remedies is guided by patient total symptoms profile rather than illness.

Homeopathy has an individualistic and holistic approach prescription according to a different types of clinical presentation of cases.

Repertorial -rubric (Boericke)

CHLOASMA-liver spots, moth patches:  ; aur.;cadm.s.; card.m.;  caul.; cob.; cur.; guar.; Laur.; Lyc.; Nat .hyposul.;Paul.;petrol.; Plumb.m.;sep.; sul.;thuya. see spots, copper-colored .

Rubric (murphy)
CHLOASMA, skin: (22) acet-ac. ant-c Ars, cadm-s. caul. coch. Con. halo. Lyc. merc-i-r.mez. nat-ars. nux-v. paull. PIb. pyrar. rob. SEP. Sol. sul-ac. sulph.

menopausal, period, in:(2) Plb. sep.

sun,agg.: (3) cadm-s. sep. sol.

Rubric (Synthesis)
CHLOASMA : (20) Arg-n. aur . cadm -s .card-m. CAUL. cob. cur. guar. laur. LYC. Nat-hp. nux-v. paull. petr. plb. raph. rob. SEP. sulph. thuj. 

FACE- Chloasma

contusion: after: (6) Am. bell . con.lach. puls. sul-ac. 

 – coppery: (7) carb-an. cor-r. merc. mez. nit-ac Rhus-t. syph.

  • spots: (4) benz-ac. lach. med. nit-ac. 

– eruption ; after: (1) med.

– dark: (1)calc- p
spots in old people (see spots – dark -old )

– darkening: (1) pitu- p.

– dirty: ( 23) ars.borx. bry  bu fo cast. Ferr. Ferr-i. ferr-pic. lod. kali-ar. merc. Nat-m Nit- ac. petr. phos. 

Plb. PSOR. sec. stram. SULPH. tarent. Thuj. tub. 

.gray: ( 1) Iod. 

CHLOASMA 🙁 18) ant-c. Ars. cadm-s. card-m caul. coch. guar. kali- p. lyc. merc-i-r. nux-v . plb . raph. rob. sep. sul-ac. Sulph. syph.

SKIN- Discolorationchloasma

-.pregnency agg. ;during: (5) caul. Con. ferr. nit-ac.  SEP. 

-sun and wind agg. ; exposure to: (1) cadm-s.

Homoeopathic therapeutics-
Sulphur- Hahnemann’s great antimiasmatc(psoric) medicine.its action is centrifugal from within out ward having an elective affinity for skin,skin is dirty filthy, every little injury suppurate,freckle , itching burning < scratching and washing, excoriation especially in folds yellowish liver spots (senile freckles) from u.v radiation from sun.stopped shoulder  with standing is worse for patient.

Sepia- it act specially on portal system with venous congestion.weakness, yellowish complexion,bearing down sensation .

Especially in women, upon whose organism. It has most pronounced effect. Chills easily.yellow blotches, pale or yellow about mouth.saddle like brownish distribution on nose cheeks.chloasma, herpetic eruption on lips,about mouth and nose.lentigo in young women. Ichthyosis with offensive odor of skin.patient have male like pelvis.ball sensation in inner part indifferent to those  loved best.

Argentum nitricum
The  skin is brown tense hard . drawing in skin as from spider web,or dried albuminous substance, irregular blotches old man’s look

Impulsive wants to do things in hurry.

Caulophyllum- women,s remedy, discoloration of skin with menstrual and uterine disorder.leucorrhoea with moth spot on forehead.ithas given with success for chloasma or pityriasis versicolor (Clarke)

Lack of tonicity of womb .it has special affinity for smaller joints .

Thuja– It has main action on skin, blood, genitourinary organ, producing conditions that correspond with Hahnemann’s sycotic dyscrasia, whose chief manifestation is wart like excrescences upon mucous and cutaneous surfaces-figwart and condylomata,freckle, blotches,sweat sweet and strong,dry skin with brown spots.dirty brown red mottled spots on hands and arms.painful sensitive itching shooting in skin specially < at night and evening.

Natrum hyposulph- (for liver spots,locally and internally)-in natrumsulph(boericke)

Lycopodium-its one of the pivotal remedy of mat.medica.spores are called veg sulphur.

Greyish yellow face with Blue Circle around eye, brown spots, freckles worse on left side of face and nose.withered shrivelled and emaciated, copper coloured eruption.

offensive secretion,viscid and offensive perspiration especially from feet and axilla.melancholy,afraid to be alone,

Apprehensive< from 4-8pm,heat.

Dr Anupma Bhushan Mishra
Associate professor Homeopathic Materia Medica)
Pt.J.lal Nehru state homeopathic medical College Kanpur Uttar Pradesh.

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