Topical treatment for postinflammatory hyperpigmentation: a systematic review

Tan, Marcus G.; Kim, Whan B.; Jo, Christine E.; Nabieva, Karina; Kirshen, Carly; Ortiz, Arisa

doi:10.1080/09546634.2021.1981814

Cited by 4 publications

(10 citation statements)

References 20 publications

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“…4 It has been suggested that topical therapies mainly act to decrease melanin production, and are most efficacious towards the epidermal component of PIH. 2,4 They may be of limited benefit treating the dermal component of PIH, as they are unable to target deposited melanin. 2,4 Other modalities such as lasers and some chemical peels may be better able to target PIH's dermal component.…”

Section: Discussionmentioning

confidence: 99%

“…2,4 They may be of limited benefit treating the dermal component of PIH, as they are unable to target deposited melanin. 2,4 Other modalities such as lasers and some chemical peels may be better able to target PIH's dermal component. 2 The mechanisms of action of laser therapies include selective photothermolysis, photoacoustic and photothermal effects.…”

Section: Discussionmentioning

confidence: 99%

“…11 Histological studies have suggested two variants of PIH: epidermal and dermal. 2,4 The epidermal histological subtype is characterized by increased epidermal melanin with minimal dermal changes. 4 The dermal histological subtype is characterized by increased melanin deposition in the dermis and dermal perivascular lymphocytic infiltrate.…”

Section: Discussionmentioning

confidence: 99%

“…2,4 Other modalities such as lasers and some chemical peels may be better able to target PIH's dermal component. 2 The mechanisms of action of laser therapies include selective photothermolysis, photoacoustic and photothermal effects. 13 Chemical peels result in resurfacing and controlled injury to stimulate the regeneration of epidermal and dermal tissue, and reduce melanin synthesis.…”

Section: Discussionmentioning

confidence: 99%

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Post‐inflammatory hyperpigmentation: A systematic review of treatment outcomes

Kashetsky,

Feschuk,

Pratt

2023

Acad Dermatol Venereol

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Post‐inflammatory hyperpigmentation is a common consequence of inflammatory dermatoses. It is more common in patients with darker skin and has significant morbidity. This systematic review summarizes treatment outcomes for post‐inflammatory hyperpigmentation to help physicians better predict clinical response and improve patient outcomes. Embase, MEDLINE, PubMed databases and clinicaltrials.gov were searched in accordance with PRISMA guidelines using a combination of relevant search terms. Title, abstract, and full text screening were done in duplicate. Studies were included if they met our predetermined PICOS framework criteria. Results are presented in descriptive form. In total, 41 studies, representing 877 patients were included. Complete response was achieved by laser and energy‐based devices in 18.1% (n=56/309) of patients, topicals in 5.4% (n=20/369), and combination therapies in 2.4% (n=4/166). Partial response was achieved by combination modalities in 84.9% (n=141/166) of patients, topicals in 72.4% (n=267/369), laser and energy‐based devices in 61.2% (n=189/309), and peels in 33.3% (n=5/15). Poor to no response occurred with peels in 66.7% (n=10/15) of patients, topicals in 22.2% (n=82/369), laser and energy‐based devices in 18.1% (n=56/309), and combination modalities in 12.7% (n=21/166). Additionally, in 2.6% (n=8/309) of patients treated with laser and energy‐based devices, post‐inflammatory hyperpigmentation worsened. Adverse events were reported in 10 patients, all while using topical treatments. In conclusion, the current treatment approaches yielded unsatisfactory rates of complete response. However, combination therapies, laser and energy‐based devices, and topical therapies showed high rates of partial response. Of note, the majority of post‐inflammatory hyperpigmentation cases included were associated with acne, and therefore the findings and conclusions drawn may have limited applicability to other types of post‐inflammatory hyperpigmentation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Post‐inflammatory hyperpigmentation: A systematic review of treatment outcomes

Kashetsky,

Feschuk,

Pratt

2023

Acad Dermatol Venereol

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“…Some of these factors include hydroquinone, thiamidol, mequinol, azelaic acid, kojic acid, arbutin, niacinamide, ellagic acid, luteolin, N-acetyl glucosamine, hexyl decanol, phytosterols, calycosin, aloesin, arginine, resorcinol and retinoids. 1,50,[68][69][70] Importantly, many of these ingredients have also a significant capacity to reduce inflammation, therefore can improve several aspects associated with PIH, particularly changes in the pigmentary unit linked to the abnormal stimulation of melanocytes in the epidermal environment. For example, azelaic acid can suppress UVB-induced expression and secretion of IL-1β, IL-6 and TNF-α and kojic acid has the potential to inhibit nuclear factor kappa B (NF-κB) activity in the keratinocytes.…”

Section: Current Treatments For Skin Hyperpigmentation: Unique Requir...mentioning

confidence: 99%

Post-Inflammatory Hyperpigmentation in Dark Skin: Molecular Mechanism and Skincare Implications

Markiewicz¹,

Karaman-Jurukovska²,

Mammone³

et al. 2022

CCID

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Human skin is characterized by significant diversity in color and tone, which are determined by the quantity and distribution of melanin pigment in the epidermis. Melanin absorbs and reflects ultraviolet radiation (UVR), preventing the damage to genomic DNA in the epidermis and degradation of collagen in the dermis; therefore, darker skin types are thought to be well protected from the photodamage because of the high melanin content. However, increased content of melanin in combination with the extrinsic stress factors causing inflammation such as excess UVR, allergic reactions, or injury can also frequently lead to cosmetic problems resulting in discoloration and scarring. This review summarizes current knowledge on histopathology and likely molecular signatures of one of the most common problems, post-inflammatory hyperpigmentation (PIH). The mechanisms proposed so far are subsequently discussed in the context of other factors characterizing darker skin types. This includes the common cellular features, organization of upper skin layers, and major biomarkers, with particular emphasis on increased propensities to systemic and localized inflammation. Enhanced or prolonged inflammatory responses can not only affect the process of melanogenesis but also have been implicated in injury-related skin pathologies and aging. Finally, we summarize the major cosmetic treatments for PIH and their known anti-inflammatory targets, which can be beneficial for darker skin tones and combined with broad-spectrum filters against UVR.

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Treatment of Post-Inflammatory Hyperpigmentation in Skin of Colour: A Systematic Review

Mar,

Khalid,

Maazi

et al. 2024

J Cutan Med Surg

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Post inflammatory hyperpigmentation (PIH) affects all skin types with a heightened predilection for darker skin tones. Its course is chronic once developed and treatment is often difficult. This systematic review aims to summarize the treatment outcomes for PIH with a focus on skin of colour (SOC) individuals. A literature search was conducted using MEDLINE (from 1946), Embase (from 1974), PubMed, and Cochrane in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline. Results from 48 studies summarized 1356 SOC individuals. The mean age was 29 years (n = 1036) and 78% were female (n = 786). The ethnic prevalence was 70% Black, 27% Asian, and 3% Latin. Overall, 20% were Fitzpatrick skin type (FST) III, 40% FST IV, 34% FST V, and 6% FST VI. Most cases were precipitated by inflammatory conditions (89%) and localized to the face (83%). The most frequently reported interventions were topical retinoids (22%) and laser therapy (17%). Partial improvement was seen in 85% and 66% of participants, respectively. Laser was the only intervention that offered complete resolution in a subgroup of patients (26%); however, there were reported cases of PIH exacerbation following treatment. Chemical peels (9%) and hydroquinone (7%) were among other treatments with less effective outcomes. PIH and its persistence is a prevalent issue, significantly affecting many affected individuals with darker skin tones. Our results show a lack of robust efficacy across all treatment modalities. There is considerable room for improvement in interventions for at-risk populations.

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Topical treatment for postinflammatory hyperpigmentation: a systematic review

Cited by 4 publications

References 20 publications

Post‐inflammatory hyperpigmentation: A systematic review of treatment outcomes

Post‐inflammatory hyperpigmentation: A systematic review of treatment outcomes

Post-Inflammatory Hyperpigmentation in Dark Skin: Molecular Mechanism and Skincare Implications

Treatment of Post-Inflammatory Hyperpigmentation in Skin of Colour: A Systematic Review

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