Hormonal Milieu in the Maintenance of Melasma in Fertile Women

Abstract

Melasma is a specific type of facial hyperpigmentation seen in women taking oral contraceptives, in non-pregnant women who have not used oral contraceptives, and in some pregnant women during the progression of gestation, but rarely in men. Circulating LH, FSH, PRL, and E2-17 beta on day 5, 7, 9, and 11 of the menstrual cycle and progesterone (P) on day 17, 19, and 21 were measured in thirty-six ovulating women with melasma (study group) age 25-35 years and twelve healthy controls (control group). Twenty-seven subjects in the study group had normal pregnancies; 9 others were married or single and had no history of contraceptive pill use. Higher levels of FSH on day 7 (p < 0.05); E2-17 beta on 5, 7, 9 (p < 0.05) and LH on day 9 (p < 0.002) were observed in the study group than in the control group. There were no significant differences between the LH/FSH ratio in the two groups. Serum PRL was lower on day 9 in the study group (p < 0.05) than in the control group. Serum P was similar in the patients and the controls. These findings indicate a possible role of high E2-17 beta in the maintenance of melasma.

Study of Hormonal Profile in Female Melasma Patients in a Tertiary Care Hospital

“…In our study out of 66 patients oestrogen level of 18 (27.3%) patients was found to be normal, while that of 48 (72.7%) was found to be deranged with either an increase or decrease, mostly increased in the estradiol levels. This is similar to the study of Khalid Mahmood et al [7] in which 89.1% showed deranged values of oestrogen (Mostly increased), while Jee et al [8] reported a dose-dependent proliferation of melanocytes in culture after 17β-estradiol addition, despite a decrease of tyrosinase activity and melanin content, Hassan I et al [9] observed higher levels of E2-17β on 5, 7, 9 day in the study group indicating a possible role of high E2-17β in the maintenance of melasma, and Kim NH et al [10] showed down-regulation of H19 and the development of melasma with a sufficient dose of oestrogen treatment.…”

“…In our study, prolactin level was found normal in 59 (89.4%) and deranged in 7 (10.6%) of the patients. This is higher than the study of Khalid Mahmood et al [7] in which prolactin levels were normal in 134 (97.1%) patients and deranged in 4 (2.9%), while Hassan I et al [9] revealed decreased and Pérez et al [13] found normal prolactin levels on 9 th day of cycle.…”

Melasma: a clinical and epidemiological review

“…There were differences in the levels of 17-β-estradiol at the beginning of the menstrual cycle among the groups, suggesting that circulating estrogens may constitute a risk factor and 'maintainer' of the disease. 65 …”

Mechanism of the Inhibitory Effect of Tranexamic Acid on Melanogenesis in Cultured Human Melanocytes in the Presence of Keratinocyte-conditioned Medium

“…Although the pathogenic mechanism is unknown, luteinizing hormone and progesterone may be involved, because melasma occasionally appears on women who take contraceptive pills, does not appear on women after menopause, and is related to pregnancy. 1,2) Moreover, it may be induced by exposure to ultraviolet (UV) radiation, especially UVA in sunlight. 3) Treatments include topical application of a depigmenting agent, hydroquinone 4) and chemical peeling using glycolic acid.…”