Freckles and its homoeopathic management


Dr Megha Sharma

ABSTRACT
Freckles are the harmless concentrations of melanin that causes black spots on the epidermis of the skin.. Common freckles themselves are safe or benign and rarely develop into skin cancer. Most freckles are developed by the exposure to ultraviolet light and faded in cold weather and Unusual-appearing freckles may become cancerous. Because skin lesions have such a strong impact on a person’s look and quality of life. From the perspective of certain journals, the goal was to determine the reason and impact of homoeopathy management in freckles. 

KEYWORDS: freckles, homoeopathy, Ephelides, Lentigines

INTRODUCTION
We live in the twenty-first century, but the prevalence of freckles is increasing. Freckles is on the rise all over the world. It was observed that many people were suffering from freckles but they were not aware of the efficacy of homeopathic system of medicine and were depending on other system of medicine like allopathic or Ayurveda or unani etc., so this is an attempt to ascertain the effectiveness of homoeopathic medicine in freckles. 

DEFINITION
Freckles are not the new word to the medical history according to Webster’s dictionary, the word freckle originates from the middle English word freckle which is likely of Scandinavian origin. It was first used in the 14th century. Freckles are tiny spots of melanin on the human skin that are flat and circular, about the size of a head metal nail. The spots will be numerous and may appear on sun-exposed skin immediately after repeated exposure to UV rays. They can be red, yellow, tan, light-brown, brown, or grey scale in colour or shade. They are more commonly seen in the summer than in the winter . 

TYPES AND CAUSES
There are two basic types – 

1 Ephelides :-  Ephelides are usually flat red or light-brown spots that usually seen in sunny months and faded in the winter season. There can be plenty of ephelides on exposed skin. They are particularly common within fair-skinned Celtic children. Ephelides embrace with exposure to ultraviolet radiation in sunlight. 

Age of onset – early childhood ,fade with ages 

Skin type- Caucasians, Asians, skin type I-II. ,Fair skin, especially with red or blond hair and blue eyes Areas affected- Face, neck, chest, arms
Relation to season- Are more prominent in summer but fade considerably or disappear in winter 

2 Lentigines :– Lentigines (singular: lentigo) are small tan, brown, or black spots which tend to become darker than an ephelids- type freckle and do not effectively fade through the winter. The quantity of melanocytes and melanosomes are normal in number and appearance.
Age of onset – Middle ages ,comes after 50 usually 

Skin type- Caucasians, Asians, skin type I–III
Areas affected- Sun-exposed skin, face, hands, forearms, chest back and shins Relation to season- Stable ,don’t disappear in the winter 

CAUSES
Freckles appear when melanin, the pigment that gives pores and skin its color, builds up underneath the skin. Sun exposure and genetic factors make some people more likely to increase freckles. Freckles can fade or disappear in winter months, while new skin cells update old cells. The existence of freckles is related to rare alleles of the MC1R gene. People with a high amount of freckling sites possess one or more associated variants of the gene. These individuals have alternative Val92Met which is furthermore present in Caucasians. 

DIFFERENTIAL DIAGNOSIS
Freckles versus liver sots
“Liver spots” or “age spots” are common names for solar lentigines at the back of the hands. The term “liver spot” is virtually a misnomer considering the fact that those spots are not resulting from liver troubles or liver sickness. 

Freckles versus moles
Most of the time it refers to a brown to black flat to slightly elevated bump. The type of cells of which the bump is composed distinguish the real nature of mole. For example, a mole composed of benign melanocytes is called a melanocytic nevus. 

REVIEW OF LITERATURE
The various studies published in reputed journal are listed below in which the factors and causes for the lentigines. 

Dubin, et. al. (1990) study found that the improvement of melanoma and non-melanoma skin malignancy is a complex interchange among hereditary and environmental risk factors. Sunlight based lentigines and ephelides are risk pointers for these skin malignant growths (1–3). 

Bastiaens (1999) concluded that the two sorts of sores are usually happening pigmented spots of the skin found prevalently on sun-uncovered skin. Sun oriented lentigines and ephelides are viewed as discrete elements and contrast in their clinical, histological and electron infinitesimal introduction (4). 

Hodgson (1963) and Ho ̈lzle (1992) studies showed the etiology of sunlight based lentigines and ephelides is probably going to appear as something else. Sunlight based lentigines are progressively common with expanding age and are viewed as an indication of photodamage (5, 6). 

Garbe et. al. (1994) in research elucidated that various names have been utilized for these spots mirroring the connection with age and constant sun presentation: sun-incited spots, burn from the sun spots, spots in adulthood, age spots, decrepit and actinic lentigines. All around directed examinations researching the connection between natural components and sun based lentigines, be that as it may, are rare. A connection between at least two burns from the sun after the age of 20 and actinic lentigines was found (7). 

Memon et. al (2004) explained a connection between actinic keratosis, and realized sun harm related skin issue, and sun based lentigines was watched (8). Jung (1986) found that the advancement of lentigines after treatment with psolaren UVA (PUVA) proposes a job for bright light (UVA)- light in the etiology of sun powered lentigines (9). 

Bastiaens et. al (2001) have indicated a solid connection between variations in the quality encoding the melanocortin-1-receptor (MC1R) and ephelides in adolescence recommending the MC1R quality is the major ephelides quality (10). 

Lawrence Chukwudi Nwabudike( 2012), has stated that melasma is a common pigmentation condition that affects the face in the majority of instances. A case of melasma that was effectively treated with the homoeopathic remedy Lycopodium(11) . 

Dr jain poonam suresh , also stated in an article that some homoeopathic medicines like lycopodium , sepia, phosphorus , acid.nitricum and etc are very much effective in management of melasma (12) 

Rasha Al-Sadoun (2021) After a comprehensive evaluation by a dermatologist, plasmage can provide promising and satisfactory results in the treatment of benign freckles for cosmetic reasons.(13) 

The motivation behind this investigation was to affirm our discoveries in a prior examination that solar lentigines are progressively common with expanding age and that these spots are not related with skin type as well as hair shading and that ephelides are less pervasive with expanding age and are fundamentally hereditarily decided (4). 

METHOD
The study review was based on various well-known journals such as Dubin et al. (1990), Bastiaens (1999), Hodgson (1963), and Holzle (1992), Garbe et al. (1994), Memon et al (2004), Bastiaens et al (2001), Lawrence Chukwudi Nwabudike, and drjain poonam suresh . 

EPIDEMIOLOGY
Age group of middles years shows higher incidences of freckles belong to this age group. Then next higher incidences is found in age group of above 45 years 

In the latest study it is found that females are more affected contributing. 

HOMOEOPATHY MANAGEMENT
Homoeopathic remedies are helpful in the case of freckles basically constitutional remedy effects more and some are therapeutically based like  

1 Lycopodium
Lycopodium (also known as club moss) is a herb native to northern Europe, North America, and the United Kingdom. This plant is a member of the Lycopodiaceae family and has a slender stem that trails along the ground as well as vertical branches. Lycopodium is a medication that is commonly used to treat liver spots or lentigines that are more visible on the face and nose.

2. Pulsatilla – For Freckles in Young Women
Pulsatilla is a Wind Flower plant-based medicine. This perennial plant is native to eastern and central Europe, Norway, and Denmark and belongs to the Ranunculaceae family.Pulsatilla has been used successfully to treat freckles in young females who have a red, hot, flushed face.

3. Thuja – For Light Brown Freckles
Thuja is derived from the young twigs of the thuja tree, also known as Arbor Vitae. This plant is native to North America and Eastern Canada and belongs to the Cupressaceae family. This remedy is effective for treating brown spots, freckles, and blotches.Thuja is best suited for pale, dry skin with dark circles under the eyes.

4. Sepia – For brown coloured Freckles
Sepia is a cosmetic treatment that is used to treat discoloration on the nose and cheeks in young women. This medicine is distinguished by a yellowish-brown saddle across the nose and wrinkled skin with spots and yellow blotches.

5. Natrum Carbonicum – For Freckles with Yellow Spots
Natrum Carbonicum, or carbonate of soda, is a mineral that is used to treat freckles on a pale face with blue rings around the eyes. It is most effective when the skin is dry, rough, and chapped, with yellow spots and pimples.

6. Phosphorous – For Freckles which Gets Worse in Summer
Phosphorus is derived from the mineral phosphorus. It is used to treat freckles with red spots that worsen in the summer or after prolonged sun exposure.
.
7. Nitricum Acidum – For Dark Freckles
This treatment is made by combining sodium nitrate and sulphuric acid. Nitric acid is most visible in dark- coloured freckles, which are frequently accompanied by pimples on the face.

8. Sulphur – For Freckles with Dry Skin derived from the mineral kingdom Sulphur sublimatum is used to make sulphur. This remedy is used to treat pale, dry skin with spotted freckles. It is best indicated when the skin appears unhealthy, with acne, an old- looking face, and circumscribed red cheeks. 

CONCLUSION
Researches show that homoeopathy remedies have more benefits to the people suffering from freckles. Homeopathy by addressing all aspects of the individual and there complete set of symptoms throw the constitutional and holistic approach is superior to all method of treatment specially in skin diseases like freckles 

Homoeopathy treatment is essentially based on “the constitutional approach” targeting the route cause and restoring the deviated immunity back to normal, there by cured the diseases. 

In other system of medicines the treatment of freckles is mainly suppressive, palliative treatment rather than curative. Commonly used local medicines like external application have there on side effects. They do not prevent or build up resentence to sub sequent exacerbation, there is a chance of re accuracy is more. 

REFERENCES  

1. Dubin N, Pasternack BS, Moseson M., “Simultaneous assessment of risk factors for malignant melanoma and non-melanoma skin lesions, with emphasis on sun exposure and related variables”, Int J Epidemiol 1990;19:811–819.
2. Green A, Battistutta D., “Incidence and determinants of skin cancer in a high-risk Australian population”, Int J Cancer 1990;46:356–361
3. Kricker A, Armstrong BK, English DR, Heenan PJ., “Pigmentary and cutaneous risk factors for non- melanocytic skin cancer – a case control study”, Int J Cancer 1991;48:650–662
4. Bastiaens MT, Westendorp RGJ, Vermeer BJ, Bouwes Bavinck JN., “Ephelides are more related to pigmentary constitutional host factors than solar lentigines”, Pigment Cell Res, 1999;12:316–322
5. Hodgson C. Senile lentigo. “Arch Dermatol”, 1963;87:197–207
6. Ho ̈lzle E., “Pigmented lesions as a sign of photodamage”, Br J Dermatol, 1992;127 (Suppl. 41): 48–50.
7. Garbe C, Buttner P, Weiss J, Soyer HP, Stocker U, Kruger S, Roser M, Weckbecker J, Panizzon R, Bahmer F., “Associated factors in the prevalence of more than 50 melanocytic nevi, atypical melanocytic nevi, and actinic lentigines: multicenter case–control study of the Central Malignant Melanoma Registry of the German Dermatological Society”, J Invest Dermatol, 1994;102:700–705
8. Memon AA, Tomenson JA, Bothwell J, Friedmann PS., “Prevalence of solar damage and actinic keratosis in a Merseyside population”, Br J Dermatol, 2000;142:1154–1159
9. Jung EG, Obert W., “The incidence of PUVA lentigines”, Photodermatology, 1986;3:46–47
10. Bastiaens MT, Ter Huurne JAC, Gruis NA, Bergman W, Westendorp RGJ, Vermeer BJ, Bouwes Bavinck JN., “The melanocortin-1- receptor gene is the major freckle gene”, Hum Mol Genet, 2001;10:1701–1708
11. Lawrence Chukwudi Nwabudike, Romania,’ Homeopathy and Melasma – A Case Presentation’ 2012; 25(2): 99-101
12. dr jain poonam suresh,” melasma in men and its homoeopathic management “, link-  https://www.homeobook.com/melasma-in-men-and-its-homoeopathic-management/
13. “ Freckle Removal and Enhanced Skin Rejuvenation by Plasmage “,Journal of Global Scientific Research 2021, 6(5)1363-1368 

Dr Megha Sharma
B.H.M.S,  PGT Pharmacy
Gurumishri Homoeopathic medical college, Jalna, Maharashtra
drmeghasharotri@yahoo.in
9818871197,8744066763
House no 1357 A sector 29 Faridabad