(232) Melasma (Chloasma)

[HB KIM]

DEFINITION

1. Melasma is also known as chloasma or the mask of pregnancy when present in pregnant women. 
2. Melasma is yellow or brown pigmentary discoloration of the skin, manifesting as macules on the face.  The symptoms of melasma are dark, irregular patches commonly found on the upper cheek, nose, lips, upper lip, and forehead. These patches often develop gradually over time.  Melasma does not cause any other symptoms beyond the cosmetic discoloration.
3. Although it can affect anyone, melasma is particularly common in women, especially pregnant women and those who are taking oral contraceptives or hormone replacement therapy (HRT) medications. 
4. It is also prevalent in men and women of Native American descent (on the forearms) and in men and women of German/Russian Jewish descent (on the face). 
5. In TCM, Melasma is known as mian chen (dusty complexion).


DIFFERENTIATION AND FORMULAS

1. LV Qi stagnation
Chai Hu  10g
Qing Pi  10g
Chen Pi  10g
Chuan Lian Zi  10g
Dang Gui  10g
Fu Ling  12g
Bai Shao (fried)  12g
Bai Zhu  12g
Hong Hua  6g
Ling Xiao Hua (Flos Campsitis)  6g
Sheng Di Huang  15g

2. LV Fire
Qing Pi  10g
Chen Pi  10g 
Mu Dan Pi (fried)  10g
Zhi Zi (charred)  10g
Ze Xie  15g
Bai Shao  10g
Tu Bei Mu (Tuber Bolbostemmatis)  15g
Ling Xiao Hua (Flos Campsistis)  10g
Ji Guan Hua (Flos Celosiae Cristatae)  10g
Mei Gui Hua (Flos Rosae Regosae)  10g

3. SP Damp
Huang Qi (fried with honey)  12g
Dang Shen  12g
Bai Zhu  12g
Fu Ling  12g
Dang Gui  12g
Hong Hua  6g
Ling Xiao Hua (Flos Campsitis)  6g
Sha Ren  6g
Bai Fu Zi  6g
Sheng Ma  6g
Shan Yao  30g
Dong Gua Pi  30g
Zhi Gan Cao  10g

4. SP Damp-Heat
Lian Zi  6g
Yi Yi Ren  6g
Sha Ren  6g
Jie Geng  6g
Bai Bian Dou  6g
Fu Ling  6g
Ren Shen 12g
Gan Cao  3g
Bai Zhu  12g
Shan Yao  12g
Hua Shi  18g
Huang Bai  6g
Huanb Qin  6g
Ze Xie  6g

5. KD Yin Deficiency
Zhi Mu  10g
Huang Bai  10g
Sheng Di Huang  15g
Shan Yao  15g
Shan Zhu Yu  10g
Fu Ling  10g
Mu Dan Pi  10g
Ling Xiao Hua (Flos Campsitis)  10g
Ji Guan Hua (Flos Celosiae Cristatae)  10g
Chai Hu  6g

6. HT Yin Deficiency
Huang Lian  10g
Huang Qin  10g
E Jiao  10g
Sheng Di Huang  15g
Tong Cao  6g
Mai Men Dong  15g
Ji Guan Hua (Flos Celosiae Cristatae)  10g
Ling Xiao Hua  10g


EMPIRICAL FORMULAS

Formula 1: Activate Blood, Cool Blood
Dang Gui  10g
Chuan Xiong  10g
Chi Shao  10g
Shu Di Huang  15g
Sheng Di Huang  15g
Bai Zhi  10g
Nu Zhen Zi  15g
Zi Cao  10g

Formula 2: Move Qi, Activate Blood
Zi Cao  15g
Qian Cao Gen  7.5g
Bai Zhi  7.5g
Chi Shao  7.5g
Su Mu  7.5g
Hong Hua  7.5g
Hou Po  7.5g
Si Gua Luo  7.5g
Mu Tong  7.5g

Formula 3: Regulate Qi and Blood
Chai Hu  6g
Dang Gui  9g
Chi Shao  9g
Bai Shao  9g
Sheng Di Huang  15g
Mu Xiang  6g
Zhi Ke  9g
Dan Shen  9g
Chuan Xiong  6g
Yi Mu Cao  15g
Ze Lan  9g
Niu Xi  15g
Zhi Gan Cao  6g

EXTERNAL USE: Grind into fine powder and mix with water to form a thin paste. Use instead of soap; massage into face for 10 minutes 2 times per day.
Mung Bean powder  90g
Bai Ju Hua  30g
Bai Fu Zi  30g
Bai Zhi  30g
Salt  15g
Bing Pian  1.5g


ACUPUNCTURE TREATMENT

TCM Acupuncture: Main points + Secondary Points
1. LV Qi stagnation: ST36, SP6, LV3 + SP9, LV2, UB18, UB20
2. SP Damp: RN12, ST36, SP6 + UB20, RN13, RN10
3. KD Yin Deficiency: KD3, SP6 + UB23, SP9
4. Local Points: Yuyao, Taiyang, SI18
5. Channels: DU14, LI11, SP10, ST36, SP6, GB20 + KD3, DU4, HT7, PC6, ST18, RN3

Auricular Points
1. Main: LV, KD, SP, Face, Endocrine
2. Empirical: Adrenal gland, Endocrine, Uterus, SP, LU