Hyperpigmentation

Abstract

Disorders of hyperpigmentation can be challenging to treat, are highly stigmatising and have a profound impact upon patients’ quality of life. In this lecture, I will discuss a stepwise approach to treating hyperpigmentary disorders. The first priority is addressing underlying causes of the pigmentation, including proactive treatment of pre-existing inflammatory dermatoses and stopping procedures that may induce post-inflammatory hyperpigmentation and considering the many pharmaceutical precipitants of pigmentation. The effect of the environment upon pigmentation and steps to mitigate this will be discussed, including the effects of sunlight upon melanocytes and the need to select a broad spectrum sunblock with protection against UVB, UVA and visible light. I will then discuss the use and integration of depigmenting agents including hydroquinone, retinoids and the emerging field of cosmeceuticals. Nuances of laser treatments for pigmentary disorders, the use of oral tranexamic acid and oral photoprotective agents will also be discussed.