Hyperpigmentation: An Overview of the Common Afflictions

Kimberly A. Cayce; Amy J. McMichael; Steven R. Feldman


Dermatology Nursing. 2004;16(5) 

In This Article

Postinflammatory Hyperpigmentation Therapy

The therapy for postinflammatory hyperpigmentation begins by treating the underlying inflammatory process. Additional treatment is very similar to those for the conditions described previously. It includes topical agents such as the retinoids, phenols, and corticosteroids or a combination of these, chemical peels, and lasers. One clinical trial evaluating the effects of 0.1% tretinoin cream on postinflammatory hyperpigmentation in black patients found significant lightening effects with the drug, but 50% of subjects in the tretinoin group experienced at least moderate dermatitis (Bulengo-Ransby et al., 1993). Another study looking at the effects of the addition of glycolic acid peels to a topical regimen of 2% hydroquinone, 10% glycolic acid, and 0.05% tretinoin cream for postinflammatory hyperpigmentation in black patients showed improved results with the peels with minimal adverse effects (Burns et al., 1997). However, as stated previously, caution must be taken when performing peels on patients of darker skin because of the increased risk of hyperpigmentation widely noted in the literature. Again, sun avoidance and use of broad-spectrum sunscreens are important. Early presentation to a physician with inflammatory conditions such as acne and atopic dermatitis is recommended to treat the primary process and, thereby, decrease the risk of hyperpigmentation. Many times, topical hypopigmenting agents are administered as postoperative treatment after procedures such as laser therapy (performed for a variety of cutaneous disorders) in anticipation of postinflammatory hyperpigmentation. Some authors even advocate use of bleaching agents preoperatively to reduce the risk (Pham, 1998).