Melasma
Melasma (chloasma) is a pigmentary skin disorder that occurs most commonly on the face of women in early or middle adulthood.
In traditional Chinese medicine (TCM) literature, melasma has also been referred to as “dark facial pigmentation,” “liver-related facial pigmentation,” “facial dust,” and “pregnancy spots.” When attributed to liver disease, it is also called “liver spots.” It is now generally referred to as dark facial pigmentation (lihei ban).
TCM Pattern Identification and Treatment Reference
| Common Symptoms
Clinical description:
Diffuse brown patches on the face, accompanied by low mood, a tendency to suppress frustration, or irritability and anger; distension and fullness in the chest and flanks; bitter taste in the mouth and dry throat; irregular menstruation and breast distension or pain before menstruation in women; a red tongue with a thin coating; and a wiry, fine pulse.
In plain language:
- Brown patches appear on the face, with diffuse distribution and indistinct borders.
- Low mood and a tendency to bottle things up, or a tendency to become irritable and lose one’s temper.
- A feeling of fullness or discomfort in the chest and along both sides of the torso.
- A bitter taste in the mouth and dryness in the throat.
- Irregular menstrual periods in women, with more noticeable breast distension and pain before menstruation.
- The tongue appears somewhat red, with a relatively thin coating.
- The pulse feels taut and fine on palpation.
| Treatment Approach
Clinical description:
Soothe the liver and regulate Qi; invigorate blood and help fade spots.
In plain language:
- May help soothe the liver and regulate the flow of Qi, easing discomfort such as distension in the chest and flanks, low mood, or difficulty belching.
- May help promote blood circulation and resolve stasis, easing manifestations such as skin discoloration, bruising, or irregular menstruation.
| Related Products
The products listed below are for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical description:
Dark brown or blackish-brown patches on the face and a dull complexion, often with a chronic illness; dizziness, tinnitus, soreness and weakness in the lower back and knees, insomnia and forgetfulness, sensations of heat and night sweats; a red tongue with little coating; and a fine pulse.
In plain language:
- Facial patches are brownish-black and appear quite dark.
- The complexion looks dull and lacks luster.
- There is often a history of a long-standing chronic illness.
- Dizziness and ringing in the ears may occur.
- The lower back and knees may feel sore and weak.
- Sleep may be poor, with insomnia and reduced memory.
- A person may often feel internal heat and sweat during sleep at night.
- The tongue appears somewhat red, with very little coating.
- The pulse is fine.
| Treatment Approach
Clinical description:
Nourish and support the liver and kidneys; nourish Yin and clear deficient heat.
In plain language:
- May help nourish and support the liver and kidneys, easing discomfort such as soreness and weakness in the lower back and knees, dizziness, tinnitus, or blurred vision.
- May help nourish Yin and clear deficient heat, easing manifestations such as restlessness and insomnia, dry mouth and throat, or hot flashes and night sweats.
| Related Products
The products listed below are for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical description:
Grayish-brown patches that look like dust adhering to the skin, accompanied by fatigue and weakness, poor appetite and drowsiness, pale menstrual blood, heavy vaginal discharge, a pale, swollen tongue with teeth marks on the edges, and a soggy or fine pulse.
In plain language:
- The patches are grayish-brown, appearing as if dust has settled on the skin, and may be slow to fade.
- Fatigue and weakness may occur easily.
- Poor appetite and persistent drowsiness may occur.
- Menstrual blood may be pale in color.
- There may be a heavy vaginal discharge.
- The tongue appears pale and enlarged, with tooth marks along its edges.
- The pulse feels soft or fine on palpation.
| Treatment Approach
Clinical description:
Strengthen the spleen and boost Qi; dispel dampness and help fade spots.
In plain language:
- May help support spleen and stomach function and replenish Qi, easing discomfort such as poor appetite, fatigue, abdominal bloating, or loose stools.
- May help dispel dampness and reduce spots, easing manifestations such as a heavy feeling in the body, skin discoloration, or swelling.
| Related Products
The products listed below are for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
| Common Symptoms
Clinical description:
Grayish-brown or dark brown patches, accompanied by chronic liver disease, or dark menstrual blood with clots, or painful menstruation; a dark-red tongue with purple spots of blood stasis; and a choppy pulse.
In plain language:
- The patches are grayish-brown or dark brown and appear quite dark and slow to fade.
- Chronic liver disease may also be present.
- Menstrual blood may be dark and contain clots, or menstrual cramps may be pronounced.
- The tongue appears dark red, with purplish spots or patches of blood stasis.
- The pulse feels rough and uneven on palpation, with an irregular flow.
| Treatment Approach
Clinical description:
Regulate Qi and invigorate blood; resolve stasis and help fade spots.
In plain language:
- May help regulate the flow of Qi and promote blood circulation, easing discomfort such as distension in the chest and flanks, abdominal distension and pain, or a dull complexion.
- May help resolve stasis and reduce spots, easing manifestations such as skin discoloration, bruising, or irregular menstruation.
| Related Products
The products listed below are for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
References
- Zhang Zhiyong. Observation of the therapeutic effects of Canji Ointment for female melasma[J]. Practical Journal of Chinese Medicine, 2013, 29(3): 70.
- Qi Yuqing, Liu Quanzhong. Clinical study of the combined treatment of melasma with different concentrations of retinoic acid and hydroquinone[J]. Journal of Tianjin University of Traditional Chinese Medicine, 2006, 12(3): 361.
- Chao Qing. Clinical observation of the therapeutic effects of compound hydroquinone cream for melasma[J]. Heze Medical Journal, 2004, 16(3): 5–6.
- Qiao Li, Yang Zhiyong, Duan Lina. Observation of the effects of Huayu Quban Capsules combined with spot-removing cream for treating 30 cases of melasma[J]. Journal of PLA Medicine (formerly North China Defense Medicine), 2011, 23(4): 82–83.
- Ou Baisheng, Liu Weibing, Chen Hongxiao, et al. Observation of the therapeutic effects of Si Bai Qu Ban Ointment combined with oral Chinese patent medicines for melasma[J]. Chinese Journal of Leprosy and Skin Diseases, 2006, 22(5): 355.
- Liu Liming. Observation of the therapeutic effects of topical medication combined with Shugan Granules for melasma[J]. Chinese Journal of Leprosy and Skin Diseases, 2015, 31(8): 461.
- Li Li. Yangrong Quban Ointment for 42 cases of facial melasma[J]. Traditional Medicine, 2009, 16(18): 72.