Hyperpigmentation Case Study

Management of hyperpigmentation disorders by various treatment modalities: Revisited
Introduction
Hyperpigmentation disorders of skin are common, non-specific, benign and manifest in a variety of different forms. The most common forms include postinflammatory hyperpigmentation, melasma, ephelides, solar lentigines, and café-au-lait macules. Hyperpigmentation disorders are the result of increase in epidermal melanin either by increased number of or activity of melanocytes. The various treatment modalities used for the treatment of these disorders includes topical agents, chemical peels, cryotherapy, or laser therapy.1
Management strategy for hyperpigmentation disorders of skin
Postinflammatory hyperpigmentation
Photoprotection
Patients should

However, response to treatment is slow, with clinical improvement taking at least 24 weeks o Isotretinoin 0.05% is used in the treatment of melasma. Clinical studies conducted to evaluate its efficacy in the treatment of melasma demonstrated that isotretinoin was associated with reduction of pigmentation o Adapalene is naphthoic derivate a potent retinoid in the treatment of melasma.
• Randomized double-blind study reported that azelaic acid was as effective as hydroquinone. However, combination of azelaic acid, with tretinoin or glycolic acid may be more effective in the treatment of melasma. This is may be due to combination therapy produces earlier and more pronounced skin lightening
• Vitamin C inhibits melanin formation and inotophoresis is used to increase the penetration of vitamin C. In a comparative study , vitamin C inotophoresis showed increase in brightness of pigmentation
• N-acetyl-4-S-cysteaminylphenol is a melanocytotoxic agent consisting of phenol, catechol, and sulphur. In a retrospective, observational study, it showed marked improvement in melasma lesions
Combination