Association of Low Serum Ferritin Levels with Melasma: A Case-Control Study at a Tertiary Care Hospital: Association of Low Serum Ferritin Levels with Melasma

Raheel Tahir; Muhammad Khurram Shahzad; Aliya Akhtar; Sadaf Badar; Chamman Farooq

doi:10.54393/pjhs.v6i9.2939

Authors

Raheel Tahir Department of Dermatology, Nishtar Medical University, Multan, Pakistan
Muhammad Khurram Shahzad Department of Dermatology, Sheikh Zayed Hospital, Rahim Yar Khan, Pakistan
Aliya Akhtar Department of Dermatology, Nishtar Medical University, Multan, Pakistan
Sadaf Badar Department of Dermatology, Nishtar Medical University, Multan, Pakistan
Chamman Farooq Department of Dermatology, Nishtar Medical University, Multan, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i9.2939

Keywords:

Melasma, Hyperpigmentation, Iron Deficiency, Serum Ferritin, Dermatology, Oxidative Stress

Abstract

Melasma is a common acquired hyperpigmentation disorder with multifactorial etiology, including hormonal influences, genetic predisposition, and environmental factors. Yet the relationship between serum ferritin levels and melasma remains unclear. Objective: To determine the association between low serum ferritin levels and melasma among patients presenting at a tertiary care hospital. Methods: This case-control study was conducted in the Department of Dermatology, Nishtar Hospital, Multan, from June 3, 2024, to December 2, 2024. A total of 114 participants were included, with 57 melasma cases and 57 age- and gender-matched controls. Serum ferritin levels were measured and compared between groups. Data were analyzed using SPSS version 23.0, with odds ratios (ORs) and p-values were calculated. Results: The mean age of participants was 24.67 ± 5.27 years and the mean BMI was 24.22 ± 2.17 kg/m². Low serum ferritin levels were significantly associated with melasma (p=0.002, OR=5.20). The association was stronger in males (p=0.002, OR=24.00), but not statistically significant in females (p=0.142, OR=2.81). Among participants with Fitzpatrick Skin Type III, the association was significant (p=0.001, OR=19.50), but not in those with Skin Type IV (p=0.490). A significant association was also observed in individuals older than 30 years (p=0.015, OR=2.66), and in non-obese participants (p=0.003, OR=4.85). Conclusions: This study demonstrates a strong association between low serum ferritin levels and melasma, particularly in male and individuals with Fitzpatrick Skin Type III, suggesting that iron storage depletion may play a role in melasma pathogenesis. Future studies should explore whether iron supplementation influences melasma severity or treatment outcomes.

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