Clinical profile and management pattern of melasma patients in Western Nepal: A Hospital Based Study

Introduction: Melasma is an acquired hypermelanosis of sun-exposed areas. Melasma is much more common in women than in men. Women are affected in 90% of cases. The patient usually presents with tan to brown patches. Multiple factors have been postulated to involve in the etiology and pathogenesis of melasma including pregnancy, oral contraceptives, genetics, sun exposure, cosmetics and race. Objectives: The objectives of the present studies are to study the demographic details of the melasma patients visiting the Manipal Teaching Hospital (MTH), to study the drugs used in management of melasma and to estimate the treatment cost to the patients. Materials and methods: We went through the records of the patient at MTH and found out the number of patients suffering from melasma and other related data from 25th November 2005 to 30th November 2007. The data obtained were analyzed as per the study objectives. Results: Altogether 107 patient files were included in the study. There were 75 (70.09%) females and 32 (29.90%) males (the total is 107). More than 50% of the patients were above the age 20 years. Most common site of occurrence of pigmentation was forehead accounting for 56.45% (n= 70) of the total case followed by cheeks 12.09% (n=15). Altogether 290 drugs were used in the patients with a Mean  SD of 2.71  0.89 drugs per patient. The Mean  SD cost of medications was NRs 458  251.36. Conclusion: The present study analyzed the clinical profile and treatment pattern of the melasma patients visiting MTH. Majority of the patients were of child bearing age. Sun screens were the most commonly employed medications followed by antioxidants 20 (6.89%) and antibiotics 18 (6.2%).