Hyperpigmentation is a common skin condition. Some parts of the skin become darker compared to the immediate surrounding skin. Let’s discuss pigmentation on the face, melasma, and hyperpigmentation including its causes. While this can be managed topically, Ayurveda also offers remedies for hyperpigmentation.
Let’s First Talk About Melanin
When melanin production increases in the skin and an excess of melanin starts depositing in the skin, it leads to hyperpigmentation.
However, hyperpigmentation is a broad term. In the ancient Ayurvedic texts, descriptions of various skin problems can be correlated to modern-day hyperpigmentation.
Skin gets its color from a pigment called melanin. Melanin is also present in hair and eyes and is responsible for their color.
Melanin is produced by a group of special cells called melanocytes. Melanocytes are present in the bottom layer of the epidermis.
People with darker skin tones have more melanin in their skin compared to others. Therefore, they are more prone to hyperpigmentation, especially when exposed to excessive sunlight.
Melanin is of three types – eumelanin, pheomelanin, and neuromelanin. Among these three types, the most common type is eumelanin.
Eumelanin further has two subtypes which are brown eumelanin and black eumelanin.
Hyperpigmentation is usually a harmless condition. Sometimes hyperpigmentation can also be an indication of some underlying disease.
Brown, deep brown or black-colored discoloration is more common in hyperpigmented skin. But sometimes pink or purple discoloration can also appear over the skin.
Hyperpigmented skin (including melasma) may be localized or more diffuse in the presentation.
Exposure to sunlight is among the most common causes of hyperpigmentation. The sun’s UV rays (ultraviolet rays) trigger the mechanism of melanogenesis.
Hyperpigmentation occurs to protect the skin cells from damaging UV rays.
Inflammation and injury of the skin may lead to hyperpigmentation.
Freckles and age spots also lead to hyperpigmentation.
Acne vulgaris may lead to hyperpigmented skin due to scarring.
A common skin condition in women called melasma is another source of hyperpigmentation. If it occurs in a pregnant woman then it is called chloasma faciei or the mask of pregnancy. In this condition, tan or dark colored patches occur on the skin.
Melasma occurrence is common in those taking contraceptives or hormone replacement therapy.
Hyperpigmentation is also associated with metabolic causes. It includes vitamin deficiencies like B12 and folic acid.
Addison’s disease and other sources of adrenal insufficiency are causes of hyperpigmented skin. In these conditions melanin synthesis is stimulated. As a result, more melanin is formed in the skin which further leads to hyperpigmented skin.
Cushing’s disease or other excessive adrenocorticotropic hormones (ACTH) production may also cause hyperpigmentation.
In Acanthosis nigricans, dark patches form on the skin in the skin folds and other areas like the armpits, groin, knees, palms, and soles of the feet. Other symptoms occur as well. It is usually associated with insulin resistance and can be a sign of pre-diabetes.
In pregnant women, a brown or dark brown vertical line usually formed over the abdomen is called linea nigra. However, this line disappears within a few months after delivery.
Certain medications like nonsteroidal anti-inflammatory drugs, cytotoxic drugs, antimalarials, heavy metals, and psychotropic drugs can promote hyperpigmentation.
Smoker’s melanosis is a brown to black pigmentation of the oral tissue. It occurs in smokers who use drugs containing nicotine. It can be seen with the naked eye.
Exposure to chemicals like salicylic acid, bleomycin and cisplatin can cause hyperpigmentation.
Mercury poisoning can lead to hyperpigmentation. It occurs when there is cutaneous exposure from topical application of mercurial ointments or skin-whitening creams.
Fungal infections like tinea cruris, tinea corporis, and tinea versicolor can also cause hyperpigmentation.
Many health conditions like celiac disease, haemochromatosis, Peutz-Jeghers syndrome, Cronkite-Canada syndrome, porphyria, Graves’ disease, Nelson’s syndrome, aromatase deficiency, allergic contact dermatitis, eczema, medullary cystic kidney disease, ichthyosis Vulgaris, some malignant conditions, and autoimmune conditions also promote the problem of hyperpigmentation.
Sometimes dermatological laser procedures can induce hyperpigmentation. Treatment for this depends upon the procedure which caused hyperpigmentation and the severity of the hyperpigmentation.
The Many Causes Of Hyperpigmentation
A person with hyperpigmented skin or melasma should visit a dermatologist or skin specialist however one can also visit a general physician.
The physician will examine your skin and take a complete medical history. These things are important while making a diagnosis for hyperpigmentation.
If any investigation related to some underlying disease is required, the physician can make a proper diagnosis and rule out the exact cause.
Management Of Hyperpigmentation
A variety of treatment options are available for hyperpigmentation. The results of these treatments depend upon the severity of the melasma or hyperpigmented skin.
Results can also vary from person to person.
When hyperpigmentation (including melasma) occurs due to some other disease, then the first line of all treatment of the underlying disease process or elimination of the causative medication responsible for the hyperpigmentation should be done.
As sunlight is a very common cause behind hyperpigmentation, protect the skin from sunlight by applying 30+ sunscreen lotions regularly.
Make sure it contains physical blockers like titanium dioxide or zinc oxide. It should be able to block both UVA and UVB rays and have an SPF of 30 or higher.
Get advice from your skin specialist for your skin type.
Also, use physical barriers for protection from sunlight including hats, sunglasses, and clothing. This will help reduce your exposure to sunlight.
A number of agents have been used topically to reduce melasma or hyperpigmented skin. However, their efficacy may vary according to the skin condition.
With chemical peels, a layer of the acid solution is used to treat hyperpigmentation.
Superficial chemical peels can be effective in managing hyperpigmentation in some conditions.
Dermabrasion is an exfoliating technique that is performed by a dermatologist or plastic surgeon.
In dermabrasion, a rotating instrument is used to remove the outer layers of the skin. This procedure makes way for new, smoother layers of skin to the surface.
Microdermabrasion is a minimally invasive procedure.
A minimally abrasive instrument is used to gently sand the skin, removing the thicker and uneven outer layer.
In microdermabrasion, tiny exfoliating crystals can also be sprayed over the skin for treatment.
Laser therapy can be effective for hyperpigmentation with durable improvement.
Lasers or light amplification are sources of high intensity monochromatic coherent light. These targeted beams of light are used to reduce hyperpigmentation.
The two types of laser therapies that are generally used are ablative lasers and non-ablative lasers.
Ablative lasers remove skin layers while the non-ablative procedure targets the dermis to promote collagen growth and tightening effects.
Ayurveda And Hyperpigmentation
The Ayurvedic texts describe a variety of skin problems including hyperpigmentation, including pigmentation on face.
According to the renowned Ayurvedic text, the Yoga Ratnakar, hyperpigmentation can be correlated with vyanga, nyasha, and neelika.
All of these skin conditions have been described under the category of kshudra roga. Kshudra roga means minor diseases.
Let’s look at each of these skin conditions individually.
Nyasha is found in any part of the body except the face. It is a large or small patch which is black or brownish-black in color and painless. The patch itself is called nyasha. It is also called laanchan.
Vyanga Or Mukh Vyanga (Pigmentation On The Face)
Due to anger and excessive physical activity Vata dosha and Pitta dosha become vitiated. These vitiated dosha form a patch on the facial skin.
The patches are painless, thin and black or brownish-black in color. They are called vyanga. It is commonly known as jhaai or chaahi.
This condition can be correlated with freckles or melasma.
When a patch of pigmentation on the face or body and is extremely black and has similar properties to vyanga, it is called neelika.
It is darker or more black in color than nyasha or vyanga.
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Hyperpigmentation In Ayurveda: Vyanga And Neelika
In the Charaka Samhita, the author Charaka described conditions like vyanga and neelika in the 18th chapter of the first section (sutra sthana). The name of the chapter is tri shotheeya adhyaya, chapter covering three types of inflammation or swelling.
These conditions were also explained under sthaniya shotha (localized inflammatory conditions).
According to the text, when aggravated Pitta dosha dries up along with rakta or blood in the skin, skin diseases like tila, pipalu, vyanga and neelika (explained above) occur.
Causes Of Inflammation (Shotha) According To Ayurveda
Inflammation occurs for the following reasons.
- Due to excision wounds and incision wounds
- Due to crumbling and fracture
- After exposure to excessive pressure and crushing
- From physical assault and serious or extensive injury
- Due to tight tying
- Due to piercing by thorns
- Due to compression or squeezing
- From contact with flowers, fruits, or juice of bhallataka or marking nut
- From contact with hairs of the Mucuna pruriens fruit
- Due to poisonous insect bite
- From contact with poisonous leaves, creepers, and shrubs
- From consuming fish
- From eating sand and mud
- From using excessive salt
Pregnancy-related problems like miscarriage can also lead to shotha. Also, if after delivery proper care is not provided to the mother, that too can lead to shotha.
Improper administration of Ayurvedic oleation therapy, fomentation therapy, emesis therapy, purgation therapy, herbal enema, oil enema, and nasya may lead to inflammation.
Following an improper diet after panchakarma, the Ayurvedic detoxification process can lead to inflammation.
Emaciation due to vomiting, intestinal problems, diarrhea, diseases related to the respiratory system, cough, anemia, abdominal problems, fever, menorrhagia, fistula in ano, and piles may also cause inflammation.
Due to kushta (various skin diseases according to Ayurveda), itching, boils and an abscess may occur.
Suppression of natural urges like vomiting, sneezing, urine, and stool can cause inflammation.
When a person becomes emaciated due to panchakarma therapies, chronic diseases or fasting and suddenly starts eating very heavy, hard to digest, sour, and salty food, inflammation can occur.
These are the general causes behind shotha roga, localized inflammatory conditions.
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Ayurvedic Remedies For Hyperpigmentation
Massage with this oil on the face may be helpful in soothing hyperpigmented skin (including melasma) (vyanga, nyasha and neelika).
Use of this oil makes the face appear clean, clear and beautiful like a full moon.
Local application of manjishtadi tailam is useful for neelika and vyanga. The oil makes the face healthy and happy. It is also moisturizing and so it may be helpful in delaying wrinkles.
It is said in the ancient texts that use of manjishtadi taila for seven consecutive days makes the face glow like gold.
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Cannabis Leaf + Vidhari Paste
Take the leaves of bhaang or Cannabis sativa, the root of vidhari or Argyreia speciosa and the root of sheesham or Dalbergia sissoo. Make a paste of all three and apply over the affected area. This is useful in problems like nyasha and vyanga.
Ankur + Red Lentil Powder Paste
Take ankur, the tender buds of the vata tree (Ficus bengalensis) and masoor daal or red lentils and grind together. Make a paste and apply locally for problems like vyanga.
Manjistha Honey Paste
Take manjishtha powder (Rubia cordifolia) and add honey to form a paste. Applying this paste topically can be useful for vyanga.
Arjuna Formula Paste
Take the bark of the arjuna tree (Terminalia arjuna), along with manjishtha (Rubia cordifolia) and arusa (Adhatoda vasica) in equal amounts. Make a powder of all three and add honey to make a paste.
Local application of this paste in helpful in vyanga.
Take jatiphala (nutmeg) powder, botanical name Myristica fragrans, and make a paste.
Local application of this paste may be helpful in vyanga and neelika.
Tumeric Milk Paste
Take milk of the madar plant (Calotropis procera) or cow’s milk and add turmeric powder to it. Apply this paste over the patches of pigmentation on the face. This remedy may be useful in hyperpigmentation.
Try iYURA Turmerisa Double-Turmeric Facial Essence
Red Lentil, Milk + Ghee Paste
Take masoor or red lentils and grind it with milk to form a paste. Add ghrita (clarified butter).
Applying this paste topically makes pigmentation on the face clean and clear in seven days, like a lotus flower.
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Please consult a qualified Ayurvedic practitioner before trying the above-mentioned remedies for hyperpigmentation, melasma, and pigmentation on the face.
- Yoga Ratnakara with Hindi commentary, uttra ardhagata, kshudra roga nidanam:41-43, page no.273, by Vaidya Laksmipati Shastri, Chaukhambha Prakashan, Varanasi, 2017.
- Charak Samhita, Sutra Sthana, 18/25, page no. 278 by Aacharya Vidyadhar Shukla and Professor Ravidutt, Chaukhamba Sanskrit Pratishthan, 2017.
- Same as reference #2, 18/4, page no.274, ^^
- Charak Samhita, Sutra Sathan, 18/6, page no. 275, ^^
- Same as reference #1, uttra ardhagata, kshudra roga chikitsa:1-6, page no.283
- Same as reference #5.
- Same as reference #5, page no.282,
- Same as reference #7.
- Same as refereence #7
- Same as reference #7
- Same as reference 1, page no.283
- Same as #11.
- Same as #11.
- Allen, Mary J. “Physiology, Adrenocorticotropic Hormone (ACTH).” StatPearls [Internet]., U.S. National Library of Medicine, 3 Mar. 2019, www.ncbi.nlm.nih.gov/books/NBK500031/.