Abstract
M.Tech. (Somatology)
An even skin tone and colour is desirable in all ethnic groups (Grimes, 2008). Skin pigmentation disorders comprise two main groups, namely, inherited and acquired pigment disorders (Karn et al., 2012). Melasma is one of the most common acquired hypermelanosis of the face (Hamadi et al., 2009). Women with Fitzpatrick skin type V-VI are more prone to melasma due to the high melanin content in these skin types (Grimes, 1999; Alam and Pongprutthipan, 2010).
Melasma is a challenging, recurrent and chronic skin condition which has become more prevalent over time due to life style changes, climate changes and global warming (Sheth and Pandya, 2011). The precise incidence and aetiology of melasma remains unclear (Hill, 2008). Classification of melasma is based on site of the lesion e.g. mandibular, malar and craniofacial; and depth of pigmentation e.g. epidermal, dermal or mixed (Kauvar, 2011).
Due to the disfiguring nature of melasma, it has been associated with significant negative psychological and emotional effects (Gupta et al., 2006). Recent studies indicate a decrease in social functioning, decreased productivity at work and lower self-esteem (Balkrishnan et al., 2003; Guinot et al., 2010; Karn et al., 2012). Grimes et al (2006) indicates that these symptoms lead to unnecessary stress, ailments, disorders and often disease.
Treating melasma in skin types V-VI is challenging and often results in poor outcomes (Balkrishnan et al., 2003, Ahluwalia, 2009). Most documented attempts have primarily relied on the use of invasive therapy, drugs and creams. These attempts include ablative and non- ablative lasers, micro-dermabrassion, mesotherapy, topical depigmenting agents like hydroquinone (HQ), arbutin, retinoids, niacinamide, mequinol, Kligman’s formula and chemical peeling (Guinot et al., 2010). Such treatment modalities have been found to produce suboptimal results and undesirable side effects and risks (Ardigo et al., 2010; Sheth and Pandya, 2011). Post inflammatory hyperpigmentation (PIH), blistering, scabbing, dyschromias, ochronosis, epidermolysis and sometimes skin atrophy are common risks associated with treating melasma on skin type V-VI (Goldberg, 2005)...