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Background Melasma is a commonly acquired hypermelanosis of facial skin due to various etiological factors including hormonal imbalance. Objectives To find out the relationship between hormonal imbalance and melasma in females. Patients and methods One hundred and fifty female patients suffering from melasma, between the ages of 17-45 years, were enrolled in the study. They were examined by Wood's lamp to see the type of melasma whether epidermal, dermal or mixed (dermoepidermal). Patients were investigated for levels of estrogen, progesterone and prolactin in two consecutive follicular and luteal phases on 9th and 18th day of cycle, respectively. Forty control cases were also investigated for the aforementioned hormonal levels in their follicular and luteal phases. Results Out of 150 patients, 138 completed the study while 12 patients were lost to follow up. Amongst the 138 evaluable patients, there were only 4 patients who had normal values for all the three hormones i.e. estrogen, progesterone and prolactin in all four phases. Fifteen patients (10.9%) had normal values of estrogen in both follicular (F1 & F2) and luteal phases (L1 & L2) while the remaining 123 patients (89.1%) had deranged values of estrogen (mostly increased) in any of the four phases. The values of progesterone were normal in 62 (44.9%) patients while they were deranged in 76 (55.1%) patients in all four phases. The levels of prolactin were normal in 134 (97.1%) patients while deranged in 4 (2.9%). Out of 40 controls, only 3 (7.5%) had increased values of estrogen in both follicular and luteal phases. Conclusion Estrogen is found to be the causative agent of melasma [ABSTRACT FROM AUTHOR]

Objective To evaluate the efficacy of Q-Switched Nd:YAG laser 1,064nm for the treatment of melasma. Methods A total of 100 patients were included in this study. Treatment area was cleansed and QSwitched Nd:YAG laser 1,064nm, was delivered with settings of 3mm spot size, energy fluence ranging from 500-700 joules and repeated frequency at 6 Hz. Clinical response was assessed by MASI score. Results A total of 100 patients were included in the study. Mean age of the patients was 31.18±5.51 years. There were 13 males (13%) and 87 females (87%). Mean duration of disease was 1.99±0.88 years. Type of melasma was as follows: epidermal 47 (47%), dermal 31 (31%) and mixed 22 (22%). Q-Switched Nd:YAG laser 1,064nm for the treatment of melasma was effective in 59 patients (59%). Conclusion 1064nm Nd:YAG laser was safe, effective and well-tolerated by all patients. [ABSTRACT FROM AUTHOR]