Vyanga – Melasma, Freckles are hyper-pigmentation disorders of facial skin with localised discoloration.
Melasma is characterised by brown patches on face, usually found on either side of the nose that occurs most often in women. It is more commonly seen in people with darker complexion. It is influenced by hormonal changes. Hence found during puberty, during pregnancy, in people with hormone replacement therapy (HRT during menopause) and oral contraceptive pills. It is triggered or worsened by sun exposure. It is typically a Pitta imbalance disorder.
Freckles are relatively easy to treat. They are small brown spots arising on face and other sun-exposed areas. They are commonly seen in children and in fair skin people. They are influenced by genetic factors.
So, melasma is patches influenced by hormones, usually found in dark complexion people.
Freckles – small circular patches, genetically influenced and found usually in young people with fair complexion.
In Ayurveda, both these conditions can be correlated to ‘Vyanga’. This word is derived by the root words – Vi + Anga. Vi refers to vikriti (derangement) and anga refers to normal body part.
Acharya Charaka defined this disorder as the disease which manifests over the face due to vitiation of vata and pitta resulting in painless(neeruja),thin(tanu) and bluish black /brown (shyama), circular patches (mandalanvita).
Causative factors for Vyanga (Hyperpigmentation):
As per Ayurveda following reasons are pointed out in the manifestation of Vyanga-
Suppression of vomiting
Heavy facial exercises like singing, reading loudly, speaking etc immediately after food
Exposure to intense heat, excessive sun exposure
Improperly carried Panchakarma
Blood vitiating factors such as wrong food combinations, excess spicy foods and so on
Factors aggravating the pitta dosha like fear, anger, grief etc
Pungent, sour and salty food
Modern science specifies the contribution of following factors in this disease-
• Excess exposure/prolonged exposure to sunlight
• Increase in oestrogen and progesterone level in the blood
• Endocrinal disorders like Addison’s disease, Cushing’s syndrome etc
• Familial predisposition – genetic factors
• Frequent exposure towards toxic cosmetics, perfumes etc
• Patients under anti convulsion therapy
• Chronic liver disorders
• Persistent anaemia and Chronic GI disorders etc
Features of Vyanga (freckles / melasma):
The features are explained based on Dosha dominance-
Vataja Vyanga – Skin appears rough with bluish black patches / spots
Pittaja Vyanga – Edges are coppery red
Kaphaja Vyanga – Edges are white and associated with itching
Raktaja- Edges are red and coppery red in the centre and associated with tingling and burning sensation.
Line of treatment
General line of treatment in Vyanga (Hyperpigmentation):
Nidana parivarjana (Avoiding the causative factors)
Siravyadha (Venesection) – a form of blood letting treatment – Skin disorders are often associated with blood vitiation with Tridosha imbalance. Apart from oral medicines etc, blood letting treatment is adopted to let vitiated blood out of the body. Though it sounds pretty primitive form of treatment, this method is still practised by many Ayurvedic doctors with success.
Pralepa (External application) – application of creams, ointments, herbal paste and so on.
Abhyanga (Oil massage) – Facial massage with certain oils indicated in skin diseases.
Nasyakarma – Nasal drops – usually for all disorders afflicting above-neck region, nasya treatment is adopted. it helps to let out toxins through nasal / oral route.
Rakta shodhaka shamanaoushadha ( Oral medication to purify the blood) – Blood purification treatment
Herbs useful in the treatment of freckles, melasma – Vyanga (Hyperpigmentation) :
These are commonly Pitta balancing and blood purifying in nature.
Cardamom – being an excellent anti oxidant, it is used in treating blood pressure, asthma, indigestion, dysuria etc.
Sariva – Hemidesmus indicus -widely used in the treatment of oligospermia, gastritis, anorexia, menorrhagia etc.
Manjista -Rubia cordifolia – used in treating gynaecological disorders, skin diseases, diabetes, UTI etc.
Turmeric – used in many forms and through many routes of administration, such as – nasal, oral, over the skin etc.
Chandana- Santalum album – useful in burning sensation in hands and feet, excessive thirst, vaginitis etc.
Lodhra- Symplocos racemosa – mainly used in bleeding disorders, diarrhoea and eye disorders.
Amla – Phyllanthus emblica – excellent anti oxidant, good for skin, liver, heart and more.
Daruharidra- Berberis aristata – used in Ayurveda to treat eye disorders, skin disorders with itching, diabetes, urinary tract diseases, etc.
Jati- Jasminum officinale
Shimshapa- Dalburgia sissoo
Ayurvedic medicines for freckles and melasma:
1. Medicines useful in establishing hormonal balance, required in melasma treatment:
Kumaryasava – used in digestive disorders, urinary tract disorders. Especially useful in melasma, to correct hormonal imbalance.
Chandanasava – Used in heavy periods, menstrual disorders
Mahamanjishthadi kashaya – widely used kashaya for skin problems, also useful in blood vitiation induced disorders such as heavy periods
Chandraprabha vati – useful in UTI, hormonal imbalance induced melasma
2. Blood purifiers, useful in both melasma and freckles:
Sarivadyasava – used in the treatment of gout, diabetes and related skin complications, skin infections. It is a natural blood detox product.
Mahatiktam kashayam – used to treat wide range of skin diseases, abscess, non healing wounds and sinuses.
Lodhrasava – Used in heavy periods, menstrual disorders, bleeding disorders, blood vitiation disorders
Kaishora guggulu – ageing skin health promoter, joint health, natural blood cleanser, useful as supportive dietary herbal supplement in many health conditions such as diabetes, skin diseases etc.
Khadirarishtha – excellent blood purifier, useful in wide range of skin disorders
Gandhaka Rasayana – used in the treatment of skin diseases, itching, chronic fever, urinary tract disorders etc.
3. Pitta pacifiers:
Kamadugha rasa – Useful in high Pitta conditions. Especially useful in freckles caused due to high Sun exposure
Godanti bhasma – used in the treatment of leucorrhoea, Fever due to Pitta imbalance, Chronic fever, cough, cold, asthma, anaemia, chest injury etc.
Pravala bhasma – used in Ayurvedic treatment of cough, asthma, bleeding disorders etc.
Patoladi Kashaya – used in the treatment of skin diseases involving itching, pigmentation and burning sensation.
Ayurvedic home remedies
Tips and Home remedies for melasma and freckles:
1. Make a mix of 10 ml of kumkumadi oil with 10 grams of turmeric powder and 50 grams of aloe vera pulp. – Make a paste. – Apply this over the affected area, 30 minutes before bath everyday.
2. Make a paste of 10 grams of turmeric powder with 50 grams of aloe vera pulp. Apply this regularly. To extend its shelf life, you can store this in refrigerator.
3. Simply rub turmeric powder over the affected areas once or twice a day. If possible, add a few drops of ghee to make a paste.
4. The drugs-tender buds of Jati (Jasminum officinarum),Vata (Ficus bengalensis), Nimba (Neem leaves) and Haridra (Turmeric-rhizome) are taken in equal quantity and fine paste is prepared. After thorough face wash this paste in applied. On drying this is washed and wiped with a clean cotton cloth.This helps to reduce the lesions of hyperpigmentation.
5.Haridra(Turmeric), Daruharidra(Berberis), Shweta palandu (white onion) and Dugdha pashana(Talcum) are taken in equal amount and fine paste is prepared.This paste is applied to the face.This relieves the complaint of hyper pigmentation without any adverse reactions.
Melasma with hormonal pills:
Usage of hormone replacement therapy (HRT) to treat menopausal symptoms is a questionable practice. Excluding some serious complications such as heavy bleeding for prolonged periods, it is not recommended. If you are prescribed with a HRT regimen, talk to your doctor if it can be replaced with natural measures for menopausal symptoms
Similarly, condom coupled with avoiding sexual intercourse in and around ovulation period is quite an effective contraceptive method rather than consuming oral contraceptive pills.
Following healthy lifestyle, avoiding repeated usage of hormonal pills to postpone periods are very useful to prevent or treat melasma.
Always use an umbrella / wide brimmed hat while going under high Sun.
Apply 2 – 3 drops of of ghee (clarified butter) or coconut oil over face and neck before going out.
Irrational use of cosmetics can also cause melasma. Always be gentle with your skin.
Vyanga is surely not a dreadful or serious disease. It has to be looked into and treated with priority so as to mask the discoloration of face. Due to cosmetic importance, irrespective of age and sex it takes main concern in the clinical practice. Minimal use of cosmetics, limiting sun exposure and rational use of hormones in treatment are key factors to prevent melasma.
Article by Dr MS Krishnamurthy and Dr Hebbar