MELASMA AND AYURVEDA

Hello friends, today we will see about MELASMA or CHLOASMA or MONKEY MASK. In ayurveda it is called as VYANG (व्यंग). Melasma can be appear in both men and women but it is more common in pregnant women,  premenopausal phase and women taking contraceptive pills or HRT.

CAUSES OF MELASMA:-

Melasma is nothing but the secretion of excessive melanin pigments from melanocytes. On stimulation ,melanocytes secret melanin pigments on skin.The causes for melanocytes stimulation are female harmones like estrogen, progesterone, specially when exposed to sun. The skin with light brown colour is more susceptible to develop melasma. Again thyroid diseases makes increase in incidents of melasma. Basically it is thought to be enhanced by surges in certain harmones. Also the skin which is weak ,thin ,undernourished is more prone to melasma. 

SYMPTOMS OF MELASMA:-

The symptoms of melasma are dark , irregular ,hyperpigmented macules that is discoloured areas  or patches commonly on upper cheek,nose, upper lips and forehead.These patches develop gradually over the time.It's only cosmetic discolouration and shows no other signs or symptoms. But melasma should be differentiated from post inflammatory hyperpigmentation, actinic lichen planus and hydroquinone induced hyperpigmentation.

MELASMA ACCORDING TO AYURVEDA:-

 As this is not  a fatal or life threatening disease ,it is mentioned under kshudra rog( क्षुद्ररोग) section in ayurveda. 

Acharya Sushruta mentioned pathogenesis for melasma in following ways

"क्रोधायास प्रकुपितो वायु:पित्तेन संयुतः।

सहसा मुखमागत्य मण्डलं विसृजत्यत:।

निरुजम तनुकं श्यावम मुखे व्यंग तमादिशेत।।

Summary for this Sanskrit shloka is , whenever​ hyper stress or irritability is there ,then it makes exaggration of vayu dosh in body with vitiation of pitta too ,which then develops black patches on face perticularly.

In practice it is found that women who suffer with problems like hyperacidity,gases or other digestive disorders are more prone to develope melasma.Also chronic illness or generalised weakness are trigger factors for melasma.

AYURVEDIC TREATMENT FOR MELASMA OR VYANG:-

 A) PANCHKARM CHIKITSA- 

Sushruta mentioned RAKTMOKSHAN chikitsa for vyang.Waman that is induced vomitting and  virechan that is induced purgation are also very very effective for keeping​ skin healthy, because these methods of panchkarm  remove all impurities from body and detoxifies  body thoroughly. Nasya with kumkumadi tailam is very effective to make skin firm and flowless . It provides nourishment to skin and also gives stimulation to pituitary gland to keep estrogen and progesterone harmones in balance and thus inhibits melasma formation.

But all these treatments need expert's supervision so should be performed by trained ayurvedic doctors only. So reach to any well trained ayurvedic doctor and  get your body detoxified . Skin is the biggest organ of body so when body is pure then  obviously skin looks sparkling.

 B) SHAMAN CHIKITSA:-

 This treatment includes oral medications to remove melasma. As this is exaggration of wat and vitiation of pitta dosh so one can take sutshekhar wati, kaamdudha wati ,shankh bhasm with honey. These medicines are useful for repairing diagestive system, making pitta dushti clear.With this virechan should be done to do watanuloman. Raktshodhak medicines like mahamanjishthadi kashay or panch tikt ghrut are also needed to take . Many other internal medicines like arogyawardhini wati punarnava mandur are useful .As stress is a trigger factor for this so one can take jatamansi fant as drinking water or jatamansi ghan wati. But the perticular medicine which will suit to you can be selected by ayurvedic doctor only ,after taking proper hystory for your problems . So I will advice not to take any self medication .  Meet to any near by ayurvedic doctor because ayurveda has a lot more to deal with this problem.

 C) EXTERNAL APPLICATIONS FOR MELASMA-

 Before selecting anything to apply on face  , one should know differentiation between skin types. Otherwise facial applications will not show expected results. So here are some differenciations between skin types

* **OILY AND DRY SKIN TYPES ***

These are common skin types which almost all people knows. Skin which secrets excessive sebum on skin is oily one and which secrets less is dry one . But  Asian people have mostly combination ​to oily kind of skin . That means skin which shows excessive oil on few parts of face  like nose and cheeks while looks dry on other parts of face. This is quite complicated kind of skin .

some structural differences are also present in skins of different races which are as follows-

1) DIFFERENCE IN THICKNESS OF SKIN

2) DIFFERENCE IN WATER CONTENT UNDER SKIN

3DIFFERENCE IN LIPID CONTENT OF SKIN

Now why these points should be considered? Actually structural differences determines effectiveness of topical creams ,scrubs ,face packs or any other external application. Also it determines healing and scarring responses of skin.

Here are some points  regarding skin types which should be considered while applying anything on face:-

1) Black skin has more cohesion or force of attraction to keep cells together than white skin. So it shows more thickness,and  needs strong, dence applications​ to get good absorption. 

2) Black and Asian skin types have thicker and more compact dermis layer than White skin. Dermis is a second layer of skin. Also these skin types have more lipids and moisture in outer most layer.  That's why Asians and blacks have fewer facial wrinkles than whites. And  they need less oil based products for external application.

3)Black and Asian skins sheds off their outer layer more than white skin.To avoid dullness and to remove excessive dead cells ,this skin needs regular exfoliation.

4) Asian skin types have highest skin ceramide levels than other skin types. Ceramides are waxy lipid molecules which prevents excessive loss of water due to evoporation and thus it is responsible to keep skin hydrated.I have already described difference between hydrated skin and oily skin  in my previous posts. Oily skin can also be dehydrated one. Pollution,wheather and improper diet are responsible factors to make skin dehydrated. It's very important to keep skin hydrated both internally and externally.

5) As we have seen before, Asian skin has thick dermis layer hence it is not much wrinkle prone but this skin has thinner outermost layer which is called as stratum corneum and also has interrupted pH levels. Because of these  properties this skin is prone to irritations​, and scars easily. Also this skin has more sebaceous glands and that's why it's more oily too. And because of all these causes Asian skin type has more issues with hyperpigmentation. 

All these are points which should be kept in mind whenever you are going to apply anything  on face regularly ,but when it comes to hyperpigmentation treatment ,then it becomes more essential to consider skin texture and structure. Here  ayurveda has proven itself the best , through all its ways of treating. All   applications  like face packs or oils are given  keeping these things in mind.

Sushruta and charaka both had described skin layers in their books. Both of them stated LOHITA(लोहिता) or asrugdhara ( असरुग्धरा) as second layer of skin that is dermis layer according to modern science. Dermis layer has connective tissues and blood vessels and also oil and sweat glands . According to Sushruta VYANG or melasma is a disease appearing in LOHITA twacha or dermis layer. 

Skin's outermost layer is composed of lipophilic cholesterol, cholesterol esters and ceramides. Obviously to get good absorption of medicine and to make  faster get through in blood circulation, we need lipid soluable substances. That's why majority of VYANG kalp are oil based. Of which kumkumadi tailam is very famous formulation. It has great potential to remove melasma or scar and it makes skin bright and flowless. But care should be taken while applying this on oily kind of skin. Many a times oily skin has some acne on it with melasma. So if one will apply oil on acne prone skin then  possibly it can cause   clogging of pores after which more pimples will grow up. But for dull ,dry, dehydrated kind of skin this is the best option. Few other oil applications are there like manjishtadi tailam, Dwiharidra tailam etc. All these oils are made up of using different herbs. But all these herbs are blood purifiers and are with astringent properties too. They  make blood pure and causes vasoconstriction to avoid recurrence of melasma  and also make skin cells tight and firm.

 Modern science is using antifibrinolytic medicines like TRANEXAMIC  ACID to treat melasma. Mechanism of action for this medicine is quiet complecated but in simple words, tranexamic acid prevents plasmin present in blood from  coming in contact with melanocytes of epidermis layer . Plasmin is responsible for stimulation of melanocytes which causes more production of melamine . So obviously it's prevention avoids melasma formation. Exactly in the same way ayurvedic oils mentioned earlier allow good absorption of medicines through skin layer in blood stream,then  constrict blood vessels to avoid  further contact  of plasmin  with melanocytes and thus stops formation of melasma ,with extra benefits of enhancement in skin texture and glow. 

Also some LEPA or face packs are there for treating the same. These face packs are supposed to be specifically ​for oily kind of skins. But as the medicine should get absorbed in good quantity and should reach faster to blood circulation , Acharya adviced to apply all these face packs mixing with substances allowing lipid solubility like milk or butter or buttermilk. Though oily or lipid soluable, still these all base products have less clogging properties so are safe to apply on oily and acne prone skin too.

To prepare these face packs take raktchandan Powder, manjishta powder,kushtha and lodhra powders. If one has too oily skin then should apply this combination mixing with milk.Make a paste of these powders with milk , apply paste on face and  massage in circular movements for five minutes,then wash  on drying. Similarly if one has combination to oily skin then apply the same combination mixing with butter and honey and do the same as above. Now if skin is thick or rough then take all these powders grinded little bit coarsely as like scrubs. This will add the benefit of exfoliation to same formula and will remove dead skin cells making skin more glowing. But if skin is thin and fragile then use fine powders to avoid skin irritation. 

Well this is all according to different skin types or conditions. One more face pack is there. Take masoor daal or lentil pulse ,grind it little bit coarsely and apply this powder with milk . This is working best on melasma and also lentil has natural bleeching properties too. This is safe for all skin types including oily,dry ,thick and thin. Also one can apply shankh bhasm with milk for the same purpose.

 

These all are treatments to cure melasma and also to avoid recurrences​ too. But with all these things, exercises and good routine habits are far more helpful to keep skin healthy.

So this is all about MELASMA. But my honest opinion is it's always better to get an expert's suggestions for both internal and external treatments. So visit any  trained graduate ayurveda doctor and then you can see magical results.