Impact of melasma on quality of life in Indian patients

Melasma in people with darker skin types: a scoping review protocol on prevalence, treatment options for melasma and impact on quality of life

BACKGROUND

Melasma is one of the most encountered dermatoses in dermatology and skin care clinics. It is a challenging chronic, recurrent condition associated with hyperpigmentation. Its aetiology is poorly understood. Melasma affects all races and gender but is more prevalent in women with darker skin types. Being a facial lesion, melasma has a severe impact on quality of life due to its disfigurement. While many modalities of treatment for melasma exists, unfortunately, effectiveness and safety remain a huge concern. Treatment modalities are variable and often unsatisfactory. The objective of this scoping review is to systemically map available evidence from literature regarding melasma on people with darker skin types, garner insight as to how melasma affects the quality of life and begin to investigate and gain understanding on effectiveness of different treatments used for melasma.

METHODS

A scoping review guided by Arksey and O'Malley's framework, the enhancements and recommendations of Levac, Colquhoun and O'Brien, Daudt and associates and the 2015 Johanna Briggs Institute's guidelines will be conducted. Systematic electronic searches of databases and search engines will include Scopus, PubMed, CINAHL Complete, Cochrane, Science Direct, and Web of Science which will be conducted to attain published peer-reviewed articles of all study designs excluding reviews and grey literature. All literature that meets the inclusion criteria, research question and sub-question will be included in this review. All the retrieved literature will be exported to an Endnote X20 library. Quality appraisal of the included articles will be conducted using the mixed methods appraisal tool (MMAT) 2018 version.

DISCUSSION

We anticipate mapping relevant literature on the melasma, investigating the effectiveness of treatment options of melasma as well as evaluating its association with quality of life in people with darker skin types. This study is likely to reveal research gaps, which could guide future implementation research on melasma treatment interventions.

SYSTEMATIC REVIEW REGISTRATION

This protocol has been registered a priori with OSF and is accessible on this link: https://osf.io/ru3jc/ .

A randomized controlled clinical trial to evaluate safety and efficacy of a Unani formulation in the management of Kalaf (Melasma)

OBJECTIVES

Kalaf (Melasma) is an acquired facial hypermelanism. It has direct impact on patient's quality of life and leads to development of various personality disorders. Lack of effective treatment and recurrences have drawn the attention of researcher to find alternative treatment. This study aimed to evaluate safety and efficacy of a topical Unani formulation in the management of melasma.

METHODS

We conducted a prospective randomized controlled clinical study on the participants diagnosed with melasma. The participants (n=72) randomized into test (n=36) and control (n=36) groups. Sixty participants (n=30 in each group) completed the duration of therapy. The participants of the test group were treated with a classical Unani formulation and control group with hydroquinone 4%. The primary end point was change in mean MASI score and secondary end point was improvement in quality of life after eight weeks of treatment.

RESULTS

The Unani formulation reduced 40.5% mean MASI score (17.31 ± 9.58 to 10.28 ± 5.92) in comparison to 32% reduction in mean MASI score (20.58 ± 9.49 to 13.92 ± 7.38) in the control group after eight weeks of treatment. When comparing with baseline the difference in MASI score was found statistically significant in both groups (p<0.05). On intergroup comparison, the change in MASI score between both groups was not statistically significant (p>0.05). In addition, MQOL and DQLI also improved significantly in both groups.

CONCLUSIONS

This study concluded that the Unani formulation and the control drug were equally effective and safer in the management of melasma.

In search of lost beauty: Experiences of Iranian women with melasma

BACKGROUND

The skin condition called melasma affects patients' appearance significantly and affects them psychologically and emotionally, besides leading to an impaired body image.

AIM

Since access to quality information in different cultural environments is necessary to understand the psychological problems associated with melasma, the aim of this qualitative study was to explore the experiences of 20 Iranian women with melasma.

PATIENTS/METHODS

The content analysis method was employed for this study. Twenty participants were selected through purposive sampling, and data were collected through face-to-face in-depth interviews and then transcribed verbatim.

RESULTS

After categorizing the initial codes, 14 subthemes were identified, which were classified under five themes-camouflage, seeking treatment, lost beauty, grief, and others' reaction; these were then grouped under a general one, "in search of lost beauty."

CONCLUSIONS

Melasma has a tremendous impact on the lives of the women it affects, and therapists should focus on the condition's social and psychological aspects, in addition to treatment.