Dept. of Dermatology is lead by

-Dr Tolongkhomba P. - MD(Dermatology)

Melasma

Melasma is a skin condition presenting as brown patches on the face of adults. The most common sites are the cheeks, bridge of nose, forehead, and upper lip.

Who gets melasma?

Melasma mostly occurs in women. Only 10% of those affected are men. Dark-skinned races like Asians, Indians, and Northern Africa, tend to have melasma more than others.

What causes melasma?

The cause of melasma is unknown. People with a family history of melasma are more likely to develop melasma. It is commonly associated with pregnancy and called chloasma, or the "mask of pregnancy." Birth control pills may also cause melasma.

Sun exposure and even very strong light from light bulbs, can aggravate melasma. Incidental exposure to the sun is mainly the reason for recurrences of melasma.

Any irritation of the skin may cause an increase in pigmentation in dark-skinned individuals, which may also worsen melasma. Melasma is not associated with any internal diseases or organ malfunction.

Diagnosis of melasma:

Because melasma is common, and has a characteristic appearance on the face, most patients can be diagnosed simply by a skin examination.

Treatment of melasma:

While there is no cure for melasma, many treatments have been developed. Melasma may disappear after pregnancy, it may remain for many years, or a lifetime.

Sunscreens are essential in the treatment of melasma. A SPF 30 or higher should be selected. Sunscreens should be worn daily, whether or not it is sunny outside, or if you are outdoors or indoors.

Any facial cleansers, creams, or make-up which irritates the skin should be stopped, as this may worsen the melasma. If melasma develops after starting birth control pills, it may improve after discontinuing them. Melasma can be treated with bleaching creams while continuing the birth control pills.

A variety of bleaching creams are available for the treatment of melasma. Normally, it takes about three months to substantially improve melasma.

Chemical peels, microdermabrasion, and laser surgery may help melasma. These procedures have the potential of causing irritation, which can sometimes worsen melasma. People should be cautioned against non-physicians claiming to treat melasma without supervision because complications can occur.

Vitiligo is a skin condition resulting from loss of colour pigment, which produces white patches. Common areas are the face, lips, hands, arms, legs, and genital areas.

Who Gets Vitiligo?

Vitiligo affects one or two of every 100 people. About half the people who develop it do so before the age of 20; about 1/5 have a family member with this condition. Most people with vitiligo are in good general health.

How Does Vitiligo Develop?

Typical vitiligo shows areas of milky-white skin. Vitiligo often begins with a rapid loss of pigment. This may continue until, for unknown reasons, the process stops. Periods of pigment loss, followed by times where the pigment doesn't change, may continue indefinitely.

The course and severity of loss of colour differ with each person. Individuals with severe cases can lose pigment all over the body but there is no way to predict how much pigment an individual will lose.

How is Vitiligo Treated?

Sometimes the best treatment for vitiligo is no treatment at all. These areas are easily sunburned, and people with vitiligo have an increased risk of skin cancer. They should wear a sunscreen with a SPF of at least 30 should be used on all areas of vitiligo not covered by clothing. Avoid the sun when it is most intense to avoid burns.

Disguising vitiligo with make-up is a safe, easy way to make it less noticeable.

Treatment can be aimed at returning normal pigment (repigmentation) or destroying remaining pigment (depigmentation). None of the repigmentation methods are permanent cures.

Repigmentation Therapy

Corticosteroids creams containing can be effective in returning pigment to small areas of vitiligo. These can be used along with other treatments. These agents can thin the skin or even cause stretch marks in certain areas. They should be used under your dermatologist's care.

PUVA

PUVA is a form of therapy where a type of medication known as psoralen is used. Then the skin is treated with a special type of ultraviolet light - UVA. Treatment with PUVA has a 50-70% chance of returning color on the face, trunk, and upper arms and upper legs. Hands and feet respond poorly. Usually at least a year of twice weekly treatments are required. Side effects of PUVA include sunburn-type reactions. When used for long time, freckling of the skin may result and there is an increased risk of skin cancer. UVA blocking eyeglasses must be worn from the time of exposure to psoralen until sunset that day to prevent an increased risk of cataracts. PUVA is not used in children under the age of 12, in pregnant or breast feeding women, or in individuals with certain medical conditions.

NBUVB

This is phototherapy where a different type of ultraviolet light is used. There is no need to take psoralen, which results in lesser side effects. This is becoming the preferred form of treatment nowdays.

Skin grafting

Treatment of Vitiligo in Children

Sunscreen and cover-up measures are usually the best treatments. Topical corticosteroids and immunomodulators can also be used. PUVA is not recommended until age 12.

Other Treatment Options

Other treatment options include a new topical class of drugs called immunomodulators and excimer lasers

Depigmentation Therapy

For some patients with extensive involvement, the most practical treatment for vitiligo is to remove remaining pigment from normal skin and make the whole body an even white color. The pigment removal is permanent.

Is Vitiligo Curable?

At present although treatment is available, there is no single cure.