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== Importance of concept ==
== Importance of concept ==
=== Importance in diagnosis & prognosis of disease ===
=== Importance in diagnosis & prognosis of disease: ===
<p style="text-align:justify;">The natural complexion indicates a state of health or natural physiological processes inside the body. Sudden spontaneous change in natural complexion may be due to some pathology. Sudden drastic change in natural complexion may also indicate death in near future. Apart from discussing the natural complexion, some of the abnormal complexions like blue, grey, coppery, green and albino (extremely white)are described. [Cha. Sa. IndriyaSthana 1/9] Example, cyanotic complexion is observed in severe right ventricular hypertrophic cardiomyopathy.<ref name="ref6" /> The abnormalities includeif half of the body has natural complexion and the other have abnormal complexion, and both of them are evenly demarcated by a line.These normal and abnormal complexions may simultaneously appear in left and right sides, front and back sides, upper and lower parts or internal and external parts of the body. Natural and abnormal complexions simultaneously appearing in face or other parts of the body, are the morbid signs indicating imminent death.[Cha. Sa. IndriyaSthana 1/10] For example, amelanotic melanomas presenting as red skin lesions are often lethal.<ref name="ref7" /></p>
<p style="text-align:justify;">The natural complexion indicates a state of health or natural physiological processes inside the body. Sudden spontaneous change in natural complexion may be due to some pathology. Sudden drastic change in natural complexion may also indicate death in near future. Apart from discussing the natural complexion, some of the abnormal complexions like blue, grey, coppery, green and albino (extremely white)are described. [Cha. Sa. IndriyaSthana 1/9] Example, cyanotic complexion is observed in severe right ventricular hypertrophic cardiomyopathy.<ref name="ref6" /> The abnormalities includeif half of the body has natural complexion and the other have abnormal complexion, and both of them are evenly demarcated by a line.These normal and abnormal complexions may simultaneously appear in left and right sides, front and back sides, upper and lower parts or internal and external parts of the body. Natural and abnormal complexions simultaneously appearing in face or other parts of the body, are the morbid signs indicating imminent death.[Cha. Sa. IndriyaSthana 1/10] For example, amelanotic melanomas presenting as red skin lesions are often lethal.<ref name="ref7" /></p>
=== Clinical diagnosis based on varna: ===
<p style="text-align:justify;">Some diseases often have an impact on varna. Thus varna can be used as one of the diagnostic criterias for identification of diseases. Examples are as follows:
* Pandu (anaemia); Pale colour. [Cha. Sa. ChikitsaSthana 16/11]
* Kamla (jaundice): Yellowish [Cha. Sa. ChikitsaSthana 16/35]
* Vitiligo: Depigmented patches over skin.
* Albinism: Depigmentation of skin.
* Cyanosis: Bluish colour (may be due to heart defect).
</p>
== Contemporary theories ==
=== Melanin vis-a-vis varna: ===
<p style="text-align:justify;">Melanin is produced by melanocytes in a process called melanogenesis. Melanin is made within small membrane–bound packages called melanosomes. As they become full of melanin, they move into the slender arms of melanocytes, from where they are transferred to the keratinocytes. Under normal conditions, melanosomes cover the upper part of the keratinocytes and protect them from genetic damage. One melanocyte supplies melanin to thirty-six keratinocytes according to signals from the keratinocytes. They also regulate melanin production and replication of melanocytes.<ref name="ref8" /> Individuals have different skin colours mainly because their melanocytes produce different amount and kinds of melanin.The genetic mechanism behind human skin colour is mainly regulated by the enzyme tyrosinase, which creates the colour of the skin, eyes, and hair shades.<ref name="ref9" /><sup>,</sup><ref name="ref10" /> Differences in skin colour are also attributed to differences in size and distribution of melanosomes in the skin.<ref name="ref11" /> Both the amount and type of melanin produced is controlled by a number of genes that operate under incomplete dominance.<ref name="ref12" /> One copy of each of the various genes is inherited from each parent. Each gene can come in several alleles, resulting in the great variety of human skin tones.</p>
=== Ultraviolet radiation & Varna: ===
<p style="text-align:justify;">Melanin controls the amount of ultraviolet radiation penetrating the skin. Moderate amount of ultraviolet radiation is required for production of vitamin D. Its excessive exposure is injurious to health. Thus, people living near equator, like natives of South Asia, Africa,etc, where the intensity of sunlight and ultraviolet radiation is more, have more melanin, hence darker skin. On the other hand, person living near pole are less exposed to sunlight and ultraviolet radiation, leading to less melanin production and hence lighter skin.</p>
=== Haemoglobin and carotene on varna: ===
<p style="text-align:justify;">The pigment haemoglobin is responsible for pinkish or reddish colour of skin. While pigment carotene is for orange colour. These skin colours are more apparent in light skin coloured individuals.</p>
=== Gender & Varna: ===
<p style="text-align:justify;">Females are usually significantly lighter in skin pigmentation than males. Females need more calcium during pregnancy and lactation. The body synthesizes vitamin D from sunlight, which helps to absorb calcium. Females evolved to have lighter skin so their bodies absorb more calcium.<ref name="ref13">Jablonski NG, Chaplin G. The evolution of human skin coloration. J Hum Evol. 2000 Jul;39(1):57-106. doi: 10.1006/jhev.2000.0403. PMID: 10896812.</ref></p>
== Assessment parameters ==
<p style="text-align:justify;">Varna can be assessed with naked eyes. However, the eyes are not able to distinguish between minute differences in skin complexion. Various devices that may be used or were used to assess the varna are the following:</p>
<ol><li style="font-weight:bold">Fitzpatrick scale: <span style="font-weight:normal">It is a numerical classification schema for human skin colour.</span></li>
<li style="font-weight:bold">Von Luschan's chromatic scale: <span style="font-weight:normal">This equipment consists of 36 opaque glass tiles which were compared to the subject's skin, ideally in a place which would not be exposed to the sun (such as under the arm).</span></li>
<li style="font-weight:bold">Skin reflectance: <span style="font-weight:normal">These devices are typically pointed at the upper arm or forehead, with the emitted waves then interpreted at various percentages.</span></li>
<li style="font-weight:bold">Brown Paper Bag Test: <span style="font-weight:normal">The ‘Brown Paper Bag Test’ is a term in African-American oral history used to describe a colourist discriminatory practice within the African-American community in the 20th century, in which an individual's skin tone is compared to the colour of a brown paper bag.</span></li>
<li style="font-weight:bold">Tele-spectroradiometers (TSRs) and spectrophotometers (SPs): <span style="font-weight:normal">TSRs are used for measuring colour appearance such as in cosmetic industry for developing skin colour charts and evaluating skin products. SPs are mainly used for diagnosing skin disease symptom, such as erythema and irritation.</span></li>
<li style="font-weight:bold">Skintone Pen TP 20:<span style="font-weight:normal">It is a battery-operated probe to determine skin pigmentation (melanin) on a scale from 0-99.</span></li></ol>
== Current researches ==
<ol><li style="font-weight:bold">Cosmetic approach of varna in Ayurveda<ref name="ref14">Sonam, Meena KS, (2019). Cosmetic Approach of Varna in Ayurveda. International Journal of Research in Medical Sciences and Technology Vol. No. 8, Jul-Dec e-ISSN: 2455-5134, p-ISSN: 2455-9059 555.</ref><br/><span style="font-weight:normal">The research article discusses the process and principles of varnotpatti (development of varna). Normal varna of an individual has to be considered under two headings: Sahaja (the colour and complexion, which is since birth, falls under this category) and Jatottara (due to exposure external factors like sun-exposure, hot atmosphere, humidity, pollution, etc sometimes the complexion of an individual becomes different from the one he was born with). </span></li>
<li style="font-weight:bold">Understanding the concept of varnotpattiin Ayurveda<ref name="ref15">Bhaurao, D.S. (2017). Understanding the Concept of Varnotpatti in Ayurveda. International Journal of Innovative Research in Medical Science, 2(09), 1341 to 1345. https://doi.org/10.23958/ijirms/vol02-i09/20</ref><br/><span style="font-weight:normal">The research article discusses the factors contributing in the formation of varna in foetal life (role of mahabhuta, semen, procreative factors, state of mind of mother, food and behaviour of mother, topography, race and genetics) and factors contributing in the process of varnotpatti after birth (role of digestive capability, food and method of consumption of food, body tissues, biological humors, metabolic wastes, ojas and age).</span></li>
<li style="font-weight:bold">The concept of varna an Ayurvedic prospective<ref name="ref16">Brahma S, Sharma MK (2018). The Concept of Varna An Ayurvedic Prospective. World Journal of Pharmaceutical Research, Volume 7, Issue 18, 450-460. ISSN 2277–7105.</ref><br/><span style="font-weight:normal">Apart from other factors, this article also discusses the relation of varna with stress,ACTH and adrenocortical secretion. Almost any type of physical and mental stress can lead within minutes to greatly enhanced secretions of ACTH and consequently cortisol as well (> 20 folds). When ACTH is secreted by the anterior pituitary gland, several other hormones like melanocytes stimulating hormone (MSH), lipotropin, and endotrophin that have similar chemical structures are secreted simultaneously. The reason for this is the gene transcribed to form the RNA molecule that causes ACTH synthesis initially causes the formation of a considerably larger protein, a preprohormone called proopiomelanocortin (POMC), which is the precursor of ACTH and several other peptides, including MSH, beta-lipotropin, beta-endorphin and few others. Under normal condition, most of these hormones are not secreted in enough quantity by the pituitary. But when the rate of secretion of ACTH is high, some of the POMC derived hormones may also be increased. The POMC gene is actively transcribed in several tissues, like cells of dermis and lymphoid tissue. In melanocytes, located abundantly between the dermis and epidermis of the skin, MSH stimulates formation of black pigment melanin and disperses into the epidermis. On the other hand within minutes the entire sequence leads to large quantities of cortisol in blood. It circulates through blood to reach skin cells. It slows down the skin cells and make cells take long time to get to the surface and peel off. Therefore, the dead skin cells enhance, resulting lifeless and looks of the skin. Along with that overstress situation moves the blood away from the skin, and a little amount of blood moves around, which turns again insufficient supply of oxygen through the skin. In this process, the skin doesn’t get the required nourishment, which results in pale and dull skin.</span></li></ol>
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