Chloasma, called “sallow spots” and “liver spots” in Chinese medicine, and commonly known as “butterfly spots” and “stretch marks”, is a kind of facial pigmentation skin disease. It is a kind of facial pigmentation skin disease. The main symptoms are: light brown or dark brown pigmented patches of different sizes on the face, usually symmetrically distributed on the forehead, around the eyes, cheeks, nose and lips, with smooth surface, no scales and clear edges, and the sunlight will deepen the pigmentation, which seriously affects the patient’s beauty. Most of the patients are female (the ratio of male to female is about 1:9), and most of them have different degrees of menstrual disorders, irritability, insomnia and other symptoms of endocrine and phytoconstitutional disorders, which seriously affect their life and health.
I. Common causes
In Western medicine, most scholars at home and abroad believe that the following factors are related: endocrine disorders, uterine ovarian diseases, genetic factors, ultraviolet radiation, tyrosine dysfunction, the use of cosmetics containing metal elements or preservatives, and the use of phototoxic drugs. Through the study of relevant clinical and basic experiments, the pathogenesis of this disease can be summarized as follows.
1, endocrine disorders: mainly sex hormone abnormalities and thyroid hormone abnormalities, sex hormones can increase melanin production by lifting the inhibitory effect of glutathione or SH (sulfhydryl) on tyrosine, thyroid hormones can promote the oxidation process of tyrosine and melanin, and reduce SH in the epidermis and increase melanin formation.
2, oxygen free radical damage: the oxidation and antioxidant balance in the body is disrupted, and the excess generation of oxygen free radicals and the activity of antioxidant enzymes in the body is reduced, resulting in damage to the structure and function of biofilm and causing melasma.
3, blood rheological changes: increased blood viscosity causes blood stagnation and leads to the occurrence of chloasma.
4. Sunlight exposure and thermal stimulation: ultraviolet light or thermal stimulation in sunlight can activate and increase the tyrosinase activity in the skin by oxidizing and destroying SH in the skin, which in turn activates melanocytes and increases the number of melanocytes per unit area and the secretion of melanin vesicles, causing skin pigmentation.
5, abnormal content of trace elements.
6, genetic factors.
7, the influence of vascular endothelial function.
8, microbial imbalance in the skin lesion area, etc.
The research and treatment of sallow spots have been studied in Chinese medicine for a long time, and the symptoms of sallow spots were first proposed in the “Yin Yang Eleven Veins Moxibustion Classic” from the Warring States to the Qin Dynasty, and its etiology and treatment were discussed in detail. At present, most doctors believe that the main cause of this disease is the dysfunction of the liver, spleen and kidneys: disorders of emotion and will, liver qi stagnation, loss of liver circulation, qi stagnation and blood stasis; strain on the spleen and earth, loss of spleen health, qi and blood dysregulation; kidney essence damage, deficiency fire inflammation; as a result, blood vessels are stagnant, qi and blood cannot be honored on the face, the facial skin is not moistened, cloudy stagnation on the face, and eventually chloasma is formed, “what goes on inside must be shaped outside”. The most common causes of chloasma are internal injury, liver qi stagnation and blood stagnation.
The people who are prone to it
1.Pregnant women
Pregnant women often start to have chloasma in the second to fifth month of pregnancy. This is because the progesterone level in women’s body will gradually rise after pregnancy, while estrogen can stimulate melanocytes to secrete melanosomes, and progesterone can promote the transfer and spread of melanosomes, which can make chloasma appear.
After a woman is pregnant, all systems of her body will change, and the skin is no exception. Pigmentation may appear on the cheeks, nipples, areolas, around the navel, the midline of the lower abdomen and the vulva. Melasma with a butterfly-shaped distribution is common on the face. It is currently believed that this may be related to the increase of melanocyte-stimulating hormone in the body after pregnancy; it may also be the result of the increase of estrogen and progesterone levels in the body after pregnancy, which stimulates melanocytes. In addition, it is also related to the individual’s constitution, and not every pregnant woman appears.
2. Sun spots formed by frequent exposure to the sun are also a common type of melasma.
Exposure to sunlight or excessive exposure to X-rays and ultraviolet rays can promote chloasma and make it intensify. Even fluorescent lamps for indoor lighting can aggravate melasma by stimulating ultraviolet rays, so it can be considered that melasma is a physical damage skin disease. Sunlight can increase the melanin activity and increase the melanin content in the basal layer of the epidermis, and chloasma will be formed.
3.Women who use cosmetics inappropriately
At present, the cosmetic market is not yet standardized, and it cannot be ruled out that some products are not qualified when they leave the factory, or qualified products are not used properly under the guidance of professional doctors, and patients blindly listen to the advertisement and apply them without authorization, thus a lot of complications and side effects appear. Most of the popular spot removal creams in the market contain peeling drugs and hormone drugs. The irregular use of these drugs can lead to the destruction of the natural protective barrier of the skin, thus leading to the disruption of the immune function of the skin and the decrease of the resistance to external damage, which makes it easier for chloasma to appear or aggravate the existing chloasma.
Improper use of cosmetics, especially blind use of spot removal products, will stimulate the skin and lead to pigmentation after inflammation. In addition, the content of zinc, copper, mercury and lead in many unqualified cosmetics exceeds the normal standard, and the skin absorbs them to enhance tyrosinase activity and accelerate melanin synthesis, on the basis of which the face is exposed to ultraviolet radiation, which activates the tyrosinase present in melanoma cells and accelerates the effect on On the basis of this, the face is exposed to ultraviolet light, which activates the tyrosinase present in the melanocytes and accelerates the action of tyrosine, making it oxidized to dopa and further oxidized to brown melanin, thus inducing aggravation of melasma.
4.Women with melasma mostly have menstrual disorders, premenstrual breast swelling, or chronic illnesses.
Chloasma is mainly caused by endocrine disorder, mental stress, various diseases (liver and kidney insufficiency, gynecological diseases, diabetes), as well as lack of vitamins in the body and stimulation of topical chemical drugs. Chloasma is also seen in chronic gastrointestinal diseases, liver diseases, tuberculosis, cancerous tumors, malignant lymphoma and chronic alcoholism. Long-term application of certain drugs can also cause chloasma.