Hlo,
I’m sorry you’re dealing with this—melasma can be very distressing, especially when it affects visible areas and self-confidence. I’ll explain it from an Ayurvedic perspective and then give prescription.
keeping in mind that you are on long-term ARV therapy.
🌿 Ayurvedic Understanding of Melasma - In Ayurveda, melasma is correlated with Vyanga / Neelika, caused mainly by: - Pitta dosha aggravation (heat, pigmentation) - Association of Rakta dhatu dushti (impure blood) - Stress & emotional factors → aggravate Pitta - Long-term medicines → affect Yakrit (liver) and Rakta - Sun exposure & hormonal imbalance
In your case:
Chronic stress Long-term ARVs Gradual spread to cheeks, eyes, ears, neck → suggests deep-seated Pitta-Rakta imbalance, so creams alone won’t work.
🎯 Treatment Principle (Ayurveda) - Cool & detoxify Pitta - Purify blood (Rakta shodhana) - Support liver - External skin repair - Strict sun protection
🧾 Ayurvedic Prescription (Generally Safe with ARVs)
🔹 Internal Medicines (8–12 weeks) 1. Mahamanjishthadi Kwath 10 ml + equal warm water Twice daily after food 👉 Best for pigmentation, blood purification OR (if decoction not tolerated) Mahamanjishthadi Ghan Vati – 2 tabs twice daily after meals
2. Arogyavardhini Vati (low dose) 1 tablet once daily after lunch 👉 Supports liver, helps medicine-induced pigmentation ⚠️ Avoid higher doses due to ARVs
3. Shatavari Churna ½ tsp with cool milk or water at night 👉 Calms Pitta, stress-related hormonal imbalance
🔹 External Application (Very Important) - NalPamaradi Tailam (Kerala oil) Apply thin layer at night only Wash with mild herbal cleanser in morning Use 3–4 times/week 👉 Safe for dark skin, improves tone gradually OR (if sensitive skin) - Kumkumadi Tailam (diluted) 2 drops oil + 4 drops aloe vera gel, nightly
☀️ Non-Negotiable Rules Mineral sunscreen SPF 50 (zinc-based) daily, even indoors Avoid heat, steam, facial massages No lemon, vinegar, scrubs, or steroid creams Avoid chemical peels without supervision
🥗 Diet & Lifestyle (Critical) ✔ Increase: Coconut water Cucumber, bottle gourd, pumpkin Amla (food form) ❌ Avoid: Spicy, fried food Coffee, alcohol Late nights & sun exposure
🧘♀️ Daily: 10–15 min Sheetali / Sheetkari pranayama Stress management is essential, not optional
⏳ Expected Results 4–6 weeks: No further darkening 8–12 weeks: Gradual lightening Deep melasma needs 3–6 months for visible change
⚠️ Important Note Because you are on ARVs, do NOT start strong rasa-aushadhi or detox Panchakarma without supervision. The above plan is gentle and compatible.
Tq
MELASMA THAT DEVELOPS AFTER LONG TERM ARV USE IS SEEN DUE TO INTERNAL HEAT HORMONAL IMBALANCE AND LIVER LOAD THIS TYPE OF PIGMENTATION IS STUBBORN BUT CAN BE CONTROLLED AND LIGHTENED WITH CONSISTENT INTERNAL TREATMENT IT IS NOT A QUICK PROCESS BUT IMPROVEMENT IS POSSIBLE WITHOUT HARSH PRODUCTS
AYURVEDIC MEDICINES WITH DOSE
MANJISHTHA CAPSULE ONE CAPSULE TWICE DAILY AFTER FOOD WITH WARM WATER
AMALAKI CAPSULE ONE CAPSULE ONCE DAILY AFTER BREAKFAST
GUDUCHI CAPSULE ONE CAPSULE ONCE DAILY AFTER LUNCH
SARIVADYASAVA TEN ML WITH EQUAL WATER ONCE DAILY AFTER FOOD IF IT SUITS YOU
FOR EXTERNAL APPLICATION AT NIGHT PURE ALOE VERA GEL APPLY THIN LAYER ON AFFECTED AREAS DAILY
CONTINUE THIS REGIMEN REGULARLY FOR AT LEAST THREE TO SIX MONTHS WITHOUT CHANGING PRODUCTS FREQUENTLY EXPECT GRADUAL LIGHTENING AND STABILIZATION NOT OVERNIGHT RESULTS
Hello I totally get how frustrating it must be to deal with melasma for three years, especially when it’s all over your face and neck, and messing with your confidence. Thanks for being so open about it. And dont worry we are here to help you out 😊
YOUR CONCERN
–Melasma for three years, pretty bad, affecting your daily life. –Dark spots on your cheeks, around your eyes, ears, and neck. –Been on ARVs for seven years. –You’ve noticed stress makes it worse. –Tried a bunch of creams, but nothing helped. –Your skin’s naturally darker now, with uneven patches.
Big, important safety note (seriously )
–Since you’re on ARV therapy, we gotta be super picky about any internal Ayurvedic medicines. –We’re gonna stay away from harsh detox stuff, metals, or strong formulas. –The main focus will be on gentle, liver-friendly support, external treatments, balancing stress and hormones, and sun protection.
AYURVEDIC UNDERSTANDING
In Ayurveda, what you’ve got sounds a lot like Vyanga, or melasma. It’s usually caused by too much Pitta dosha (that’s like heat and pigmentation), Rakta dushti (an imbalance in your blood), stress from hormones and metabolism, a long-term load on your liver from meds, and emotional stress (which is a huge deal here). This is why those creams haven’t done squat.
CAN MELASMA BE FIXED??
Yes, you can manage it, and it can definitely get a lot lighter. But you’ll need patience, consistency, and the right approach – no quick-fix creams here. It might not vanish completely right away, but you’ll see a noticeable change.
AYURVEDIC PLAN (ARV-friendly):
1. What you can use on your skin (most important):
Natural Face Pack (2-3 times a week): –Mix sandalwood powder, manjistha powder, and a little rose water. –Put a thin layer on the dark spots for 15-20 minutes. –Wash it off with regular water (no scrubbing). –It’s safe, cooling, and helps with the dark spots over time.
Aloe Vera Gel (Daily): Use pure, unscented aloe vera gel. Put it on the affected areas at night. Super safe with ARVs.
INTERNALLY (Generally safe options)
1.Amla (Indian Gooseberry) powder: Half a teaspoon once a day with warm water. (Gently helps your liver and skin.)
DIET PLAN
✅INCLUDE Cooling foods, lots of water, fruits (papaya, apple, pomegranate), green veggies, home-cooked meals.
❌AVOID Very spicy foods, fried foods, too much sugar, alcohol, late-night eating.
SUN AND SKIN CARE (crucial for melasma):
Wear broad-spectrum sunscreen every day (even indoors if it’s bright). Cover your face and neck when you’re outside. Don’t use harsh soaps, peels, or scrubs.
Managing stress (a big trigger for you) Stress makes melasma worse. Try deep breathing, light yoga, getting 7-8 hours of sleep, and some gentle self-care.
Your melasma isn’t your fault. Long-term meds and stress can kick it off. With a gentle, safe, and consistent plan, getting better is totally possible. We gotta respect your ARV treatment and work with it, not against it.
Warm Regards Dr. Snehal Vidhate
1.Panchtikta ghrita guggulu 1 tab twice daily with water after meals 2.Arogyavardhini vati 2 tab twice daily with water after meals 3.Mahamanjisthadi kwath 20 ml with 20 ml water twice daily after meals 4.Kumkumadi taila- massage gently with this oil and leave it overnight
⚠️ Important Considerations - Consistency is key: Ayurvedic medicines often take 2–3 months to show visible improvement. - Avoid triggers: Excess heat, spicy food, stress, and harsh sun exposure worsen pigmentation. - Dietary guidance: Favor cooling foods (cucumber, coconut water, leafy greens), avoid fried/oily items. - Lifestyle: Gentle yoga, pranayama (esp. Sheetali and Anulom Vilom), and adequate sleep support healing.
Melasma is manageable but challenging to fully cure – especially on darker skin & with ARVs (some drugs like zidovudine can worsen pigmentation). Stress & sun are common triggers. But Good news is 50–80% improvement possible with consistent natural care (3–12 months)
Medicines Manjisthadi Kwath – 20 ml + 60 ml warm water morning empty stomach Kaishore Guggulu – 2 tablets morning + night after food Gandhak Rasayan – 250 mg morning + night with water Sarivadyasava – 20 ml + 40 ml water after lunch & dinner Kumkumadi Taila – for local use daily Warm Kumkumadi Taila – gentle massage on affected areas (cheeks, eyes, ears, neck) morning & night and leave 30 min then rinse (gold-standard for melasma lightening).
Diet Give daily: moong khichdi + ghee, pomegranate, coconut water, beetroot juice 100 ml. Avoid completely: spicy/sour, dairy after noon, excessive salt/sugar, sun exposure.
Lifestyle Strict sun protection – SPF50+ broad-spectrum sunscreen daily, hat/umbrella outdoors (melasma worsens with UV). Stress reduction: Anulom-Vilom pranayama 10 min daily (your main trigger). Sleep 10 PM – 6 AM.
Regards Dr Gursimran Jeet Singh MD Panchakarma
I understand, how distressing this has been for you, especially when the pigmentation has changed your natural skin tone and affected your confidence melasma that appears after years of stable health often gets triggered by internal factors like long-term meditation, stress, hormonal shifts, and liver related metabolism changes, even if you’ve tried many creams, external treatment alone, usually does not work in such cases because the root causes internal you being on ARV’s, make it even more important to choose support your remedies and not harsh product
From an Ayurvedic point of you, this type of deep facial pigmentation reflects internal eat imbalance and impaired detoxification along with stress involvement, so the approach has to be slow, safe and inside out
Internally, you can start on
Amlaki rasayana 1 teaspoon with warm water twice daily Guduchi syrup twice daily after food Mahamanjistadi aristha 20 ML with equal amount of water twice daily after meals Triphala churna 1 teaspoon with warm water at night
This medicine will help gradually correct internal imbalance and support skin clarity over time without interfering with long-term treatments
Apply aloe vera gel directly on affected areas daily Nalapramadi tailam-apply all over face, do gentle massage and wash after 30 minutes
During the day time, use sunscreen, zinc based
Avoid harsh, bleaching agent, scrubs, chemical peels steroid cream
Avoid excessive and exposure, hot, spicy, oily food and very late night
Drink enough water and keep meals regular
As you are on ARV, please do not stop or change your current medical treatment and inform your treating doctor before starting any new internal medicine. Ayurveda slowly safely and in Deep pigmentation like this visible lightening usually starts after 3 to 4 months with continued improvement over 6 to 9 months.
