Introduction

Skin color is related to a number of factors. The constitutive pigmentation of the skin is inherited genetically, without interference from solar¹ radiation. Its optional color is reversible and can be induced by sun exposure [1]. The skin is classified into six phototypes, according to the ability of each person to tan, as well as sensitivity and redness when exposed to the sun [1]. In Brazil, most cases of female Melasma develop between 23 and 35 years of age. Higher phototypes because they are more evident are easier to treat when compared to lower phototypes [2]. Melasma has different risk factors, including Ultraviolet Radiation (UVR) and hormones, including combined Oral Contraceptive Intake (OCA) and the period of pregnancy.

In addition to anticonvulsant medications, thyroid diseases and polycystic ovaries, foods containing flavonoids, alcoholic beverages, intestinal parasites, liver disease, Hormone Replacement Therapy (HRT), cosmetics such as aggressive acids for chemical exfoliations, laser, inflammatory skin processes (such as acnes), variation in cortisol and excessive physical activity [3]. Suggesting that the etiology of Melasma is multifactorial, with genetic contribution and hormonal and environmental factors. In order to evaluate and diagnose Melasma, the dermatologist’s optical perception is used in most cases, however, in clinical practice there are different equipment for detecting pathologies, observing inflammatory tissue and orbicular vessels, identifying a cellular disorder in greater quantity in the affected skin. The use of wood light equipment helps in the identification and initial predominance of the diagnosis for the treatment of Melasma [4].

Case Report

A 47-year-old female patient diagnosed with Melasma for 27 years, always undergoing various treatments to try to reverse it, however none was effective. The patient also reported low selfesteem, deprivation of social life and lower productivity, including depression. The cell method developed by JCG was applied, which is registered and patented, composed with natural assets such as glycolic extract of marigold 2.5%, growth factor egf 0.5, aloe vera 0.5%, panthenol D 10% and glycolic extract of chamomile 2, 5%. To apply the cell method, the microneedling pen was used to release the sodium and potassium channels in the cell, facilitating the subcutaneous permeation of the assets.

The treatment was carried out in two sessions, with an interval of 20 uninterrupted days, including in the summer, since it is at this time that Melasma demands more attention and care. The cell method helps in the order of melanocytes, calming, deflating and clearing. The benefits of applying this method improve the patients quality of life and self-esteem, making them understand that Melasma has to be treated constantly, making positive results indefinitely without the stain returning. In Figure 1, the patient presented the entire facial region affected by Melasma. Figure 2 shows the result after the cell method, with a significant improvement of 90% after the second session.

Discussion

The treatment with the cell method showed an important and impressive improvement after the first 40 days of application. Melasma patients report suicide attempts, lack of recognition in front of the mirror, demotivation when leaving home, isolation, high stress, anguish, eating disorders, psychological disorders and resistance to new treatments [5]. Despite the various treatments described for Melasma, its treatment remains a major challenge. Adverse effects are possible after the use of peels, acids, laser and microneedling with a greater possibility of subcutaneous inflammation. With the treatment of the cell method, we observed a 90% reduction in inflammation and recovery of the cellular order. The treatment included the use of daily Homecare products and sunscreen every 3 hours. We recommend the regular use of photo protectors and thermal water - or cold water, when the skin is exposed to excessive heat such as body activity, cold and fluorescent light, generating sensory information that affects these cells.

Although Melasma is more frequent among latinos, the exact prevalence is unknown. Approximately 66% of Mexican women develop Melasma, and a third of these women maintain pigmentation for life. It is worth mentioning that the attempts of several treatments are very damaging to the skin, thus creating resistance to new treatments, which end up taking around 2 to 3 months to observe the effective results [6]. The patient’s satisfactory report of healthy skin showed another side, for those who suffer from this pathology, identifying the dissatisfaction of self-image and the frequent use of acid treatments that have a constant rebound effect, causing frustration for both the patient and the patient-doctor. This is the first study that presents an innovative treatment, which instead of igniting, calms the melanocyte, ordering the synthesis of melanin, keeping it under control with the Homecare treatment. Therefore, this work showed that the cell method can be an important tool in improving Melasma, especially in patients with more sensitive skin and who have undergone several chemical treatments.

References

1. Otberg N (2011) Biology of Melanocytes. In: Fitzpatrick 47. The melanocyte Its structure, function, and subpopulations in skin, eyes, and hair. Dermatol Clin. 4-10.
2. Wolff K (2004) Dermatology in General Medicine. v 1 New York: Mcgraw-Hill 20.
3. Abdel-Malek ZA, Scott MC, Furumura M, Lamoreux ML, Ollmann M, et al. (2001) The melanocortin 1 receptor is the principal mediator of the effects of agouti signaling protein on mammalian melanocytes. J Cell Sci 114: 1019-1024.
4. Narciso M (2015) Dermatologia essencial. 1. ed. Rio de Janeiro: Elsevier cp.97.
5. Oliveira AA, Gonçalves PF, Santos KS, Duarte SFP, David IR, et al. (2019) Impacto do Melasma na Autoestima de Mulheres. Id on Line Rev. Mult. Psic 13: 435-443.
6. Handel AC, Miot LDB, Miot HA (2014) Melasma: a clinical and epidemiological review. An. Bras. Dermatol 89: 771-782.