1. Melasma & Ephelis Pharmacology IV (PHL 425)
Dr. Abdulaziz Bin Saeedan
PhD, Pharmacology

2. Melasma (Chloasma ) Is a tan or dark skin discoloration
It can affect anyone but is particularly common in women
Prevalent in men and women of Native American, German, Russian, and Jewish descent
Affected areas include cheek, forehead, nose, chin and arms
Melasma does not cause any other symptoms beyond the cosmetic discoloration.

3. Melasma

4. Melanosomes
 Melanosomes are the organelles, found in melanocytes (pigmentproducing cells) in which melanin synthesis occurs.
 They are :
- Oval-shaped, membrane-bound bodies - contain enzymes for the biosynthetic pathway of melanin - are identified by the DOPA reaction.
Morphological pathway of melanosome formation
 Melanosomes are formed from two sources:
 From the SER – pre-melanosomes are formed by coalescence of vesicles, and appear to contain parallel filamentous contents.
 In the RER and Golgi complex, tyrosinase and other enzymes are synthesized and packaged into vesicles. These fuse with the premelanosomes.

5. Biology of melanocyte

6. Cause of melasma Light : UVA, UVB, visible light
Hormone : pregnancy, contraceptive pill
Drug : anti-malarial drug, tetracycline
Cosmetic : perfume, color
Genetic:
Malnutrition : liver dysfunction, B12 def.

7. Type of melasma Epidermal melasma Dermal melasma
Mixed epidermal dermal melasma

8. Effective therapy Retard melanocyte proliferation
Inhibit melanosome formation
Promote melanosome degradation

9. Treatment Avoidance Sunscreen Medication : Chemical peeling
Hydroquinone: inhibits tyrosinase, an enzyme involved in the production of melanin.
Azelaic Acid: thought to decrease the activity of melanocytes
Retinoic Acid: increases skin cell (keratinocyte) turnover. This treatment cannot be used during pregnancy
Chemical peeling
Dermabrasion
Laser

10. Laser treatment for melasma
Target chromophore is melanin.
Should destroy melanocyte in hair follicle.
Good in dermal and mix melasma

11. Ephelis (Freckles)
Freckles are clusters of concentrated melanin, usually friendly, small tan or light brown spots on sun-exposed skin
Freckles themselves are quite harmless and rarely develop into skin cancer
They are particularly common in people of fair complexion on upper-body skin areas like the cheeks, nose, arms, and upper shoulders. They may appear on people as young as 1 or 2 years of age
Freckles are thought to develop as a result of a combination of genetic tendency (inheritance) and sun exposure

12. Freckles

13. Treatment
Several safe and effective methods are available to help lighten or reduce the appearance of freckles.
Frequently, multiple or a combination of treatments may be required for best results.
Freckles can easily recur with repeated UV exposures.
Not everyone's skin will improve with similar treatments.
Bleaching or fading creams: Products containing hydroquinone and kojic acid
Retinoids, tretinoin, tazarotene, adapalene
Cryosurgery: A light freeze with liquid.
Laser treatment:
Photofacials or Intense Pulsed Light treatments.
Chemical peels.