Friday, February 21

Melasma natural treatment - Melasma home remedies

Melasma natural treatment and home remedies for melasma
Melasma natural treatments aim to inhibit tyrosinase enzyme activity, to aid excessive skin turnover or to block transfer of melanosomes to the keratinocytes.
A number of organic compounds present in plant sources have these melanogenesis inhibitive or desquamation properties. Natural treatment for melasma can be tried out with many of these ingredients at home.

Traditional natural melasma treatments

All over the world there are continuous efforts to find ways to lighten melasma hyperpigmentation. Traditionally many home ingredients such as lemon juice, apple cider vinegar, turmeric paste, onion juice, oatmeal, honey, papaya paste, horseradish juice and yogurt are applied separately or in the combination of two or more as natural treatment for melasma.

Lemon juice for melasma
Lemon juice application is a well known traditional natural melasma treatment. Lemon juice is about 5% to 6% citric acid. Citric acid is an alpha hydroxy acid and is an excellent peel. Lemon juice promotes epidermal turnover and also skin desquamation. Fresh lemon juice can be applied directly on the brown discoloration patches once a day. Lemon juice removes excess oil on the skin. Frequent use may cause dry skin. Moisturizer may be applied later to hydrate the skin.

melasma hyperpigmentation on the face
melasma on the face
Papaya paste or juice for melasma
Papaya paste contains papain, a protease, which breaks down the top layer of epidermis and helps in exfoliation. The dead cells and skin debris are removed by the paste. The paste may be removed and the face washed after ten minutes. In this melasma natural treatment care must taken not add any latex from the fruit skin, as it may irritate the skin.

Oatmeal and honey scrub
Oatmeal is a natural skin scrub and helps in exfoliation. Apply the mix on the face with gentle circular motion. Remove the mask after ten minutes by washing with tepid water. Honey is a natural moisturizer.

Apple cider vinegar for melasma
Apple cider vinegar application is the traditional natural melasma treatment. Apple cider vinegar contains dilute acetic acid and malic acid. These acids stimulate skin turnover and also have bleaching effect. Apple cider vinegar is diluted with equal quantity of water and the solution is applied on the brown patches once a day.

Turmeric paste
Turmeric powder is made from the processed rhizomes of Curcuma longa (aka turmeric plant). The natural active ingredient in turmeric is curcumin. Curcumin is a potent antioxidant and help in the skin desquamation. Turmeric paste is made by mixing the turmeric powder with milk. Turmeric paste is applied daily for melasma treatment.

Horseradish juice
Horseradish juice is extracted from the horseradish roots. The juice is directly applied on the melasma spots. It promotes exfoliation of the skin and natural lightening of the melasma patches.

Plant sources with tyrosinase inhibiting compounds

Tyrosinase is a copper-containing mono-oxygenase enzyme responsible for the conversion of tyrosene amino acid into dopa (3,4-dihydroxy-phenyl-ananine) and synthesis of melanin pigment in the skin. The excessive pigment production is the main cause of melasma. A number of organic compounds from plant origin such as aloesin, linoleic acid, arbutin, ellagic acid and epigallocatechin gallate have been found to be tyrosinase inhibitors. These compounds can be effectively used in natural melasma treatment.

Aloe vera gel melasma treatment
Aloe plant gel contains an natural organic compound known as aloesin, (2-acetonyl-8-beta-d-glucopyranosyl-7-hydroxy-5-methylchromone). Aloesin inhibits tyrosinase enzyme activity. Aloe vera gel penetrates skin slowly and tyrosine hydroxylase and 3,4-dihydroxyphenylalanine (DOPA) oxidase activities of tyrosinase are inhibited in the melanocytes.

Grape seed oil treatment
Grape seed oil is extracted from the seeds of grape seeds. Grape seed oil is widely used in the cosmetic preparations and is the preferred carrier oil. Grape seed oil is a efficient moisturizer. Grape seed oil contains high concentration of linoleic acid which functions as a tyrosinase inhibitor and helps in resolving melasma.

Evening primrose oil treatment
Evening primrose oil is the oil extracted from the seeds of the evening primerose plant. Evening primrose oil is a traditional treatment of skin problems like eczema, psoriasis, and acne. Evening primrose oil contains high concentration of GLA (gamma-linolenic acid). Linolenic acid is a proven natural melasma treatment.

Sea-buckthorn (Hippophae rhamnoides) berries
Hippophae rhamnoides (aka common sea-buckthorn) is found on fixed dunes and sea cliffs. Hippophae rhamnoides is a traditional herbal plant with many medicinal uses attributed to its berries. Barkat Ali Khan et al, in their study have found that applying the extract of the berries is an effective melasma natural treatment. The effect is due to catechins, gallic acid, flavonoids, quercetin, organic acids present in the extract.

Golden Shower plant (Cassia fistula) pods
Cassia fistula is a common ornamental plant in the Indian Subcontinent and Southeast Asia. Its flower is the national flower of Thailand and the state flower of Kerala in India. It is used as a natural medicine. Barkat Ali Khan et al in their study on whitening efficacy have found that the extracts of the dried pods of the plant show melasma lightening effects. The effects are due to natural catechins, gallic acid, flavonoids, quercetin, organic acids present in the extract.

Bearberry extract treatment
Arbutin is extracted from Arctostaphylos uva-ursi (aka bearberry plant). Arbutin is a glycoside and is a glycosylated hydroquinone with tyrosinase inhibiting properties. Arbutin is used in skin lightening cosmetic preparations. It is an effective natural treatment for melasma. Arbutin is also found in wheat and the pear skins.

Green tea treatment
Green tea is rich in antioxidant polyphenols including epigallocatechin gallate (EGCG) and ellagic acid. Both EGCG and ellagic acids are known to inhibit tyrosinase and reduce skin pigment production. Concentrated extract of green tea obtained by boiling it in water can be applied directly to reduce melasma hyperpigmentation.

1.Ball Arefiev KL, Hantash BM. Advances in the treatment of melasma: a review of the recent literature. Dermatol Surg. 2012 Jul;38(7 Pt 1):971-84.
2.Barkat Ali Khan, Naveed Akhtar, Irshad Hussain, Khwaja Asad Abbas, Akhtar Rasul. Whitening efficacy of plant extracts including Hippophae rhamnoides and Cassia fistula extracts on the skin of Asian patients with melasma. Postepy Dermatol Alergol. 2013 August; 30(4): 226–232.
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Picture author: Elord from Wikidocs | License: CC BY-SA 3.0
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Melasma natural treatment and home remedies

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Thursday, February 13

Melasma treatment - Melasma prevention

Melasma treatment - Melasma prevention
At present there is no cure for melasma hyperpigmentation. However there are several treatment options for reducing the melasma hyperpigmentation and improving the cosmetic looks.
Cosmetic camouflage can be tried when the hyperpigmentation is mild.

The first step in the treatment and prevention of melasma is to avoid the exacerbating factors. Exposures to sunlight, oral contraceptive pills, hormone replacement medication, and perfumes in the cosmetic preparations are known to trigger the hyperpigmentation.

Melasma treatment

Melasma during pregnancy may clear spontaneously without treatment after childbirth. Melasma due to hormone treatments, oral contraceptive pills, medications, chemicals, cosmetics and perfumes may resolve gradually after the withdrawal of the triggering factor. Sunscreen usage and sun avoidance are very necessary to achieve the results.

For persistent or chronic melasma, several treatment options like application of hypopigmenting agents, bleaching agents, chemical peels and natural products are available. Procedures like microdermabrasion and laser treatments are also possible. Successful treatment of melasma hyperpigmentation increases the self-confidence and self-esteem in the patients.
Melasma hyperpigmentation on the face
picture of melasma on face
Image by Elord  |  CC BY-SA 3.0

Topical melasma treatment

In the topical treatment of melasma the hypopigmenting agents and/or bleaching agents are applied on the affected area of skin. The excess production of is the basic cause of . Tyrosinase enzyme converts dopamine to melanin.
Hydroquinone is the hypopigmenting agent of choice and it blocks the enzymatic pathway of tyrosinase in the production of melanin. Hydroquinone in combination with one or more bleaching agents is found to give good results. Hydroquinone creams and its combinations are available in 2% or 4% strength and the later strength is available on a prescription. In some patients hydroquinone creams can cause skin irritation and worsen the hyperpigmentation.
Kligman formula
Kligman formula was developed by Dr. Albert Kligman, a famous dermatologist in US. The patented original formulation contained 2 to 5 percent hydroquinone, 0.05 to 1.0 percent retinoic acid and 0.1 percent dexamethasone. The formulation is found to be very effective against melasma. Many effective triple cream modifications are now available with the pharmacists.
Tri-Luma® Cream is a brand of triple-combination topical cream which is claimed to be FDA-approved melasma treatment. Tri-Luma contains 0.01% fluocinolone acetonide, 0.05% tretinoin and 4% hydroquinone. The fluocinolone acetonide is a mild corticosteroid helpful in reducing inflammation. The tretinoin is a exfoliating and bleaching agent bringing about cell turnover and exfoliation. The hydroquinone is the depigmenting agent which interrupts enzymatic process leading the melanin synthesis.
Tretinoin (all-trans retinoic acid or retinoic acid) is the carboxylic acid form of vitamin A. Retinoic acid promotes loss of pigment by increased turnover of epidermis. It also reduces the tyrosinase activity. However the effects take longer time to become apparent. The melasma treatment with retinoic acid may cause side effects like inflammation, erythema, burning and sore sensation, dry skin and scaling. Some patients may have hyperpigmentation.
Topical corticosteroids, such as hydrocortisone are skin lightening agents, which can lighten the skin as well as reduce inflammation. But such lightening is highly reversible on exposure to sunlight. The topical corticosteroids may inhibit the melanogenesis. In some patients corticosteroid monotherapy has caused skin irritation, inflammation and dermatitis.

Depigmentation agents and chemical peels

Apart from the hydroquinone, retinoids and corticosteroids there are many other depigmentation agents and chemicals which are effective in the control of melasma.
Azelaic acid
Azelaic acid occurs naturally. Azelaic acid is a nonphenolic, nine-carbon dicarboxylic acid. It inhibits tyrosinase, DNA synthesis and mitochondrial enzymes. Azelaic acid reduces the free radicals and has cytotoxic effects toward abnormal melanocytes. Azelaic acid does not cause depigmentation of normal skin. Azelaic acid is safe for longterm use and it can be used even during pregnancy.
Kojic acid
Kojic acid (5-hydroxy-2-hydroxymethyl-4-pyrone) is derived from certain species of fungi. Kojic acid is an antioxidant and inhibits tyrosinase production. Kojic acid formulations can cause irritation and contact dermatitis. Hence these formulations may be tried only when the firstline formulations are ineffective.
Glycolic acid
Glycolic acid is a skin lightening agent which promotes epidermal turnover and desquamation. it also has inhibitory effects on the tyrosinase and reduces the melanogenesis. In some patients skin irritation is caused by the application of glycolic acid.
Ascorbic acid
Ascorbic acid is a potent antioxidant. 25% L-ascorbic acid is known to inhibit melanin pigment production. However it is highly unstable as a topical cream. It requires appropriate binding agents for efficacy. It is almost devoid of ill effects.
Niacinamide (nicotinamide) is the active form of vitamin B3. Niacinamide has no action on the tyrosinase enzyme activity. Skin lightening is achieved by its property of blocking the transfer of melanosomes from melanocytes to the keratinocytes. After four weeks of melasma treatment significant results are achieved.
Topical methimazole
J.Malek et al have treated two persons having melasma which was not responding to 4% topical hydroquinone (HQ). Application of topical 5% methimazole (MMI) for 8 weeks resulted in near complete clearing of the lesions. As methimazole is an oral anti-thyroid medication, the levels of the thyroid hormones after a 6-week treatment were monitored. It showed no change in serum TSH, free thyroxine, and free triiodothyronine levels as well as no detectable serum MMI levels. Topical application of methimazole appears to be a promising alternative to hydroquinone.
Mequinol (4-hydroxyanisole, hydroquinone monomethyl ether), arbutin (beta-D-glucopyranoside derivative of hydroquinone), deoxyarbutin, 4-hydroxy-anisole, 2,5-dimethyl-4-hydroxy-3(2H)-furanone, rucinol, N-acetyl-4-S-cysteaminylphenol, alpha-tocopheryl Ferulate and resveratrol are other skin lightening/depigmenting agents under research for treatment of melasma.

Microdermabrasion for melasma

In microdermabrasion abrasive materials are used to exfoliate the epidermal layers of the skin. This procedure can improve melasma, but several sittings may be required for good results. In some patients this procedure may induce inflammation and hyperpigmentation. Sunscreen and anti-inflammatory creams must be applied after microdermabrasion.

Laser treatment of melasma

Treatment with lasers produced mixed results. In some patients melasma had worsened when there was inflammation after the procedure. Many patients required repeated sittings to get visible results. The Fraxel laser (a type of fractional laser) is found to give better results and the Dual 1550/1927 Fraxel laser has been approved by FDA for the treatment of skin pigmentation problems like melasma.

Melasma natural treatment

A number of botanical compounds and their synthetic derivatives have been found to have positive results in lightening the melasma lesions. Some of the natural compounds and their sources are:
  • Aloesin (aloe vera),
  • cinnamic acid (cassia and ginseng),
  • linoleic acid (unsaturated fatty acid),
  • orchid extracts,
  • epigallocatechin gallate (green tea),
  • dioic acid (from oleic acid),
  • silymarin (thistle plant),
  • genistein (soybeans),
  • diadzein (soybeans),
  • gentisic acid (Gentian roots) and
  • ellagic acid (strawberries, green tea).
Oral medication in melasma treatment
Tranexamic acid, a synthetic derivative of the amino acid lysine, is prescribed for treatment and prevention of blood loss, especially during surgery and also in dysfunctional uterine bleeding. It is known to decrease melanogenesis in the melanocytes and provide fast and sustained lightening of melasma lesions. As it has a potential risk of thrombosis, its use is not yet universally recommended for the treatment of melasma.

In a placebo-controlled trial oral proanthocyanidin plus vitamin A, C, and E were administered on patients with bilateral melasma with encouraging results by the end of eight weeks. Pycnogenol, a plant extract containing procyanidins showed a decrease in melasma lesions after 30 days.
Melasma prevention
For the successful treatment, resolution and prevention broad spectrum sunscreen with sun protection factor (SPF) of at least 30 and physical light blocking agents like zinc oxide and titanium dioxide is required. Both the UV-A and UV-B spectrum are to be blocked. Melasma tends to be a chronic skin disorder which may be kept in check by avoiding the triggering factors. Melasma treatments fail when adequate sun protection measures and avoidance of excessive sun exposure are lacking.

1.Rashmi Sarkar, Shikha Chugh, Vijay K Garg. Newer and upcoming therapies for melasma. Indian J Dermatol Venereol Leprol. 2012 Jul-Aug;78(4):417-28.
2.Ball Arefiev KL, Hantash BM. Advances in the treatment of melasma: a review of the recent literature. Dermatol Surg. 2012 Jul;38(7 Pt 1):971-84.
3.Debabrata Bandyopadhyay.Treatment OF melasma. Indian J Dermatol. 2009 Oct-Dec; 54(4): 303–309.
4.Malek, J., Chedraoui, A., Nikolic, D., Barouti, N., Ghosn, S. and Abbas, O. (2013), Successful treatment of hydroquinone-resistant melasma using topical methimazole. Dermatologic Therapy, 26: 69–72. doi: 10.1111/j.1529-8019.2012.01540.x
Picture source: blemish.jpg
Picture author: Elord from Wikidocs | License: CC BY-SA 3.0
Current topic in natural skin care:
Melasma treatment and prevention.

Get glowing skin complexion. Remove acne scars and blemishes from face.