A Cross-Sectional, Multicentric Clinico-Epidemiological Study of Melasma in India

Abstract

BackgroundMelasma is one of the most common pigment disorders seen by a dermatologist and often occurs among women with darker complexion (skin type IV–VI).AimsThe present study aimed to investigate the epidemiology of melasma in the Indian population and to focus on the regional variability in the demographics, clinical manifestations and factors that precipitate this condition.MethodsThe present multicentric study conducted across four regions in India enrolled patients (>18 years) diagnosed with melasma on Wood’s light examination. Patients were examined to identify the distribution of melasma. Various precipitating and etiological factors for melasma were documented.ResultsThe mean age of the 331 enrolled patients with melasma was 37.2 ± 9.3 years. The prevalence of melasma was higher in females with a female to male ratio of approximately 4:1. The overall population with family history was 31%, highest in the northern region (38.5%) and lowest in the eastern region (18.2%). The two prominent patterns of distribution were centrofacial (42%) and malar (39%). Only 35% of the patients were using sunscreens. Of these, 10% of the patients used sunscreen with SPF >50. The usage of sunscreens was observed to be highest in the north (69%). About 51% of women with multiple pregnancies had a history of melasma when compared with single women (25%) or with no pregnancy (24%).ConclusionsIn conclusion, the result of the study showed that there was a regional variability in the demographics, clinical manifestations and factors that precipitate melasma among patients in India. There was a strong correlation between the family history and prevalence of melasma. Sun exposure is a major precipitating factor in melasma, but only 10% of the patients used sunscreen with SPF >50. Other factors such as concomitant medication, chronicity of disease, multiple pregnancies and use of oral contraceptives might precipitate melasma.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-014-0046-1) contains supplementary material, which is available to authorized users.

Role of oxidative stress in melasma: a prospective study on serum and blood markers of oxidative stress in melasma patients

“…In agreement with various previous studies, centrofacial melasma was the most common pattern followed by malar variant 3,[15][16][17]. Most of the patients were females with a female to male ratio of 4.55 : 1.…”

Recent progress in melasma pathogenesis

“…An effort to inhibit triggering factors or signaling pathways involved in melasma could help to improve the effects of popular therapeutic modalities (Table ). The results of epidemiological studies examining the roles of family history, UV irradiation, and pregnancy/contraceptives in melasma (Achar and Rathi, ; Goh and Dlova, ; Guinot et al., ; Handel et al., ; Hexsel et al., ; KrupaShankar et al., ; Moin et al., ; Tamega Ade et al., ) differ across broad ranges, suggesting that these findings are of limited value. Experimental data from melasma patients have largely been obtained from microscopic or immunohistochemical studies.…”

Clinical profile of 300 men with facial hypermelanosis

“…2 However, sun exposure remains the most important exacerbating factor for 55%-100% patients. 12 Most of mide (1 patient), thiomersal (1 patient) and paraben mix (1 patient) correlating clinically with their cosmetic use (Fig. 2).…”