Publication:

Clinico-investigation on epidemiological study in 119 Indian cases of melasma

Background Melasma, a multifactorial disease, constitutes the most common facial melanosis in Indian population.

Methods 119 cases of melasma aged 18 years or above were enrolled. Detailed history, examination and laboratory investigations were done.

Results 20 (16.8%) were males and 99 (83.2%) females. Mean age was 35.25 years. Disease duration was more than 1 year in 102 (85.7%), 6 months to 1 year in 10 (8.4%) and less than 6 months in 7 (5.9%). 22 (18.49%) had occupation-related increased duration of sun-exposure 19 (86.3%) or heat-exposure 3 (13.6%). 79 (66.4%) had skin type IV, 26 (21.8%) type III, 14 (11.8%) type V. Centrofacial was commonest distribution pattern in 87 (73.1%), malar in 30 (25.2%), mandibular in 2 (1.7%). Mean duration of daily sun-exposure was 53.36 minutes (male-124.75, female-38.94). Mean Melasma Area and Severity Index (MASI) score was 11.602. There was significant association between MASI and skin type (p<0.001). Other etiological factors were: Oral Contraceptive Pills (OCPs) use in 17 (17.17%), melasma during pregnancy in 39 (39.4%), family history of melasma in 24 (20.2%), hair dye use in 66 (55.5%), cosmetics use in 19 (16%), mustard oil use in 31 (26.1%), mustard oil along with other oil(s)’ use in 39 (32.8%). Laboratory investigations revealed anemia in 60 (50.42%), dyslipidemia in 73 (61.34%), abnormal thyroid function test in 26 (21.85%), serum vitamin B12 deficiency in 35 (29.4%) and vitamin D deficiency in 94 (79%).

Conclusions Higher skin phototypes should be cautious about general measures and associated risk factors (hair dye/oils, cosmetics). Increased daily sun-exposure, OCPs use, pregnancy, thyroid disorders are risk factors. Housewives and indoor occupations should be advised physical sunscreens for protection against infra-red radiation. Anemia, dyslipidemia, thyroid dysfunction, vitamin D and B12 levels can be assessed although their exact role in perpetuating/precipitating melasma needs further studies