Consensus on management of acne-induced post-inflammatory hyperpigmentation: an Indian perspective
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20205923Keywords:
Acne, Post-inflammatory hyperpigmentation, Treatment, Photoprotection, Depigmenting agentsAbstract
Post-inflammatory hyperpigmentation (PIH) is a multifactorial disorder linked to alterations in melanin pigment because of inflammatory skin condition or any injury. Acne-induced PIH is one of the common presentations observed in dermatological consultations in India, especially in females of younger age group. A wide range of topical depigmenting agents are available for effective clearance of hyperpigmentation in patients affected with acne. Besides, chemical peels and cosmetic procedures like lasers and light therapies are commonly employed. However, treatment of acne-induced PIH is challenging in Indian clinical settings for multiple reasons such as relapsing of the condition and long-standing nature of the disease; the tendency of treatment to cause pigmentation; insufficient clinical data on natural ingredients; and lack of clinical practice guidelines, exclusively for the management of PIH in Indian patients. An experts’ panel discussion involving dermatologists all over India was conducted to review the evidence-based concept of acne-induced hyperpigmentation, and to obtain expert opinions on effective and practical management of acne-induced PIH in Indian settings. This article outlines consensus expert opinions aimed at identifying, diagnosing, and managing acne-induced PIH using topical depigmenting agents in Indian patients. It also highlights effective preventive strategies, the role of patient counselling and education regarding awareness about the disease and its treatment strategies.
Metrics
References
Taylor S, Grimes P, Lim J, Im S, Lui H. Post-inflammatory hyperpigmentation. J Cutan Med Surg. 2009;13(4):183-91
Davis EC, Callender VD. Post-inflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. 2010;3(7):20-31
Kubba R, Bajaj A K, Thappa D M, Sharma R, Vedamurthy M, Dhar S, et al Post-inflammatory hyperpigmentation in acne. Ind J Dermatol Venereol Leprol. 2009;75(S1):54
Chandra M, Levitt J, Pensabene CA. Hydroquinone therapy for post-inflammatory hyperpigmentation secondary to acne: Not just prescribable by dermatologists. Acta Derm Venereol. 2012;92(3):232-35
Vashi NA, Kundu RV. Facial hyperpigmentation: causes and treatment. Br J Dermatol. 2013;169(3):41-56
Eimpunth S, Wanitphadeedecha R, Manuskiatti W. A focused review on acne-induced and aesthetic procedure-related postinflammatory hyperpigmentation in Asians. J Eur Acad Dermatol Venereol. 2013;27(1):7-18.
Akinboro AO, Ezejiofor OI, Olanrewaju FO, Oripelaye MM, Olabode OP, Ayodele OE, et al. The impact of acne and facial post-inflammatory hyperpigmentation on quality of life and self-esteem of newly admitted Nigerian undergraduates. Clinic Cosmet Investigat Dermatol. 2018;11:245.
Oram Y, Akkaya AD. Refractory postinflammatory hyperpigmentation treated fractional CO2 laser. J Clin Aesthet Dermatol. 2014;7(3):42-4
Bae YC, Rettig S, Weiss E, Bernstein L, Geronemus R. Treatment of post-inflammatory hyperpigmentation in patients with darker skin types using a low energy 1,927 nm non-ablative fractional laser: A retrospective photographic review analysis. Lasers Surg Med. 2020;52(1):7-12
Arora P, Sarkar R, Garg VK, Arya L. Lasers for treatment of melasma and post-inflammatory hyperpigmentation. J Cutan Aesthet Surg. 2012;5(2):93-103.
Del Bino S, Duval C, Bernerd F. Clinical and biological characterization of skin pigmentation diversity and its consequences on UV impact. Int J Mol Sci. 2018;19(9):2668
Zawar V, Agarwal, M, Vasudevan, Biju V. Treatment of postinflammatory pigmentation due to acne with Q-switched neodymium-doped yttrium aluminum garnet in 78 Indian cases. J Cutan Aesthet Surg. 2015;8(4):222-6
See JA, Goh CL, Hayashi N, Suh DH, Casintahan FA. Optimizing the use of topical retinoids in Asian acne patients. J Dermatol. 2018;45(5):522-8
Leyden J, Stein-Gold L, Weiss J. Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatol Ther (Heidelb). 2017;7(3):293-304
Nouveau S, Agrawal D, Kohli M, Bernerd F, Misra N, Nayak CS. Skin Hyperpigmentation in Indian Population: Insights and Best Practice. Ind J Dermatol. 2016;61(5):487-95
Patel AB. Postinflammatory hyperpigmentation: Review of pathogenesis, prevention, and treatment. Pigment Int. 2014;1:59-69
Callender VD, St Surin-Lord S, Davis EC, Maclin M. Postinflammatory hyperpigmentation: etiologic and therapeutic considerations. Am J Clin Dermatol. 2011;12(2):87-99
Silpa-Archa N, Kohli I, Chaowattanapanit S, Lim HW, Hamzavi I. Postinflammatory hyperpigmentation: A comprehensive overview: Epidemiology, pathogenesis, clinical presentation, and noninvasive assessment technique. J Am Acad Dermatol. 2017;77(4):591-605
Hollinger J, Kunal Angra K, Halde R. Are natural ingredients effective in the management of hyperpigmentation? A systematic review. J Clin Aesthet Dermatol. 2018;11(2):28-37
Ortonne JP, Bissett DL. Latest insights into skin hyperpigmentation. J Investig Dermatol Symp Proc. 2008;13(1):10-4
Kang HY, Valerio L, Bahadoran P, Ortonne JP. The role of topical retinoids in the treatment of pigmentary disorders: an evidence-based review. Am J Clin Dermatol. 2009;10(4):251-60
Sarkar R, Arora P, Garg KV. Cosmeceuticals for Hyperpigmentation: What is Available?. J Cutan Aesthet Surg. 2013;6(1):4-11
Matsuo M, Sasaki N, Saga K, et al. Cytotoxicity of flavonoids toward cultured normal human cells. Biol Pharm Bull. 2005;28:253-59.
Chaowattanapanit S, Silpa-Archa N, Kohli I, Lim HW, Hamzavi I. Post inflammatory hyperpigmentation: A comprehensive overview: Treatment options and prevention. J Am Acad Dermatol. 2017;77(4):607-21.
Downloads
Published
How to Cite
Issue
Section
