Management Of Hyperpigmentation Research Articles

An updated review on facial hyperpigmention disorder and treatment

Abstract: Skin health is an important aspect of glamour and reflects the overall wellbeing of the whole body. Facial and neck hyperpigmentation have been posing a challenge towards a complete cure in skincare and cosmetology. The root cause of hyperpigmentation is excessive production of melanin induced by the enzyme tyrosinase and also excessive production is related to exogenous factor-like cosmetics and perfumes, and endogenous factor-like hormonal imbalance during pregnancy. There are many types of hyperpigmentation including post-inflammatory hyperpigmentation (PIH), periorbital hyperpigmentation, exogenous ochronosis, which are a few to mention. Though many innovative therapy techniques and newer products have been introduced in cosmetology, nevertheless efficient management of hyperpigmentation continues to be a challenge in health care and hence presents an area of research interest for dermatologists and scientists to develop novel methods. The recent addition in skincare is the sheet masks, which are considered to be the most productive and trending technique of drug delivery for skin rejuvenation. Sheet masks are beneficial because they are toxin-free and are the perfect carrier to our skin. Having realized the scope of innovation in cosmetology, the present review article revisits different types of hyperpigmentation conditions developed due to drug use and/or other causes and potentiality of sheet masks in the management of hyperpigmentation disorder. Also, it is envisaged that this review article may be of interest among dermatologists, other health care researchers, and manufacturing chemists to develop new strategies in skincare.

Hyperpigmentation: Looking beyond hydroquinone

Hyperpigmentation is the most common complaint in the age group 40-45years, seeking consultation for skin disorders. Hydroquinone is a commonly used depigmenting agent in clinical practice for treating hyperpigmentation. Prolonged use of hydroquinone has been associated with cancer risk and exogenous ochronosis. The CARES (The Coronavirus Aid, Relief, and Economic Security Act) Act of 2020has instituted significant changes to hydroquinone containing OTC (over the counter) products, and consequently, many hydroquinone-based OTC products had to be withdrawn from the market. Henceforth, products containing hydroquinone would need US Food and Drug Administration approval via new drug application pathways for commercialization. Alternative treatment options to hydroquinone in clinical practice are reviewed in this paper with regard to their safety and efficacy vis a vis hydroquinone. Also, new potential treatment options such as thiamidol, Polypodium leucotomos, and glutathione are discussed. The review shows that these alternative depigmenting agents can be rationally combined to achieve desired treatment goals in the management of hyperpigmentation.

Expert opinion on current trends in hyperpigmentation management: Indian perspective

<p class="abstract">Hyperpigmentation is a common pigmentary disorder characterized by increased production of melanin. It is present in Asian skin phototypes, with a higher prevalence in the Indian population. Skin heterogeneity is seen in more than 80% of individuals of all age groups and genders in several cities across India. In children, the prevalence of hyperpigmentary disorders accounts for 1.54 per 1000 children.Sixty expert dermatologists participated in expert group meetings via teleconference webinar to elaborate on the current trends in the management of hyperpigmentary disorders. The major reasons for hyperpigmentary disorders in India include melanocyte function followed by exposure to ultraviolet radiation, race, ethnicity, use of medications, pregnancy, and use of cosmetic. There are wide varieties of skin-lightening or depigmenting agents and skin resurfacing procedures that aid in the management of hyperpigmentation. However, treatment becomes challenging due to compliance issues related to affordability, complexity of prescriptions, and treatment duration. Compliance increases only if the patient sees any improvement or discontinues treatment due to higher expectations. Hence, the success of the treatment lies in patient adherence. This article summarizes expert opinions on identifying, diagnosing, and managing hyperpigmentation with the help of topical depigmenting agents in the Indian scenario. It also emphasizes treatment adherence issues along with the role of patient counseling and education regarding disease awareness and treatment strategies.</p>

Differential diagnosis and management of hyperpigmentation.

There is an increasing recognition of ethnic dermatology to reflect the increase in skin of colour (SOC) populations in the UK. Hyperpigmentary disorder is one of the commonest skin concerns in SOC but there has been limited training available in this field of dermatology. Variations in skin colour are genetically determined by the amount of melanin content, the eumelanin/pheomelanin ratio and the size of melanosomes, but is also influenced by other factors such as hormones and extrinsic factors such as ultraviolet radiation. Hyperpigmentation is a broad term to describe increased pigmentation in the skin, and making a correct diagnosis is an important first step in the successful management of hyperpigmentary disorders. A systematic approach based on the disease pathogenesis (e.g. reactive vs. nonreactive, increased melanin vs. increased number of cells or epidermal vs. dermal pigmentation) aided by a detailed history and clinical examination is the best way to diagnose a hyperpigmentary disorder. Based on its pathogenesis, management can be planned. For epidermal hyperpigmentation caused by increased melanin, topical skin-lightening agents targeting inhibition of tyrosinase or melanosome transfer and promotion of keratinocyte turnover can be used. Hydroquinone-containing cream is the gold-standard treatment for epidermal hyperpigmentation. Alternative treatments include laser toning or chemical peels. However, increased dermal pigmentation is more challenging to target with topical treatments. If hyperpigmentation is due to increased numbers of melanocytes or keratinocytes, high-fluence laser is the most appropriate treatment method.

Peptides in cosmeceuticals

Skin aging is part of human global aging which becomes evident along the years following different ways in organs, tissues and cells. Aging of the internal organs is masked whilst the skin is the first organ displaying visible signs of passing time. As life expectancy is growing everywhere at a fast pace, many people are on a quest for the fountain of youth, and age usually factors into the perception of beauty.Peptides feature molecules constituted by chains of two or more amino acids connected by peptide bonds. There are a lot of physiological peptides present in the organism, most of them having a signalling function. Due to the potent activity of these physiological peptides, it was tempting using their model and mimic them in order to get focused therapeutic activities. This trend was initiated in the beginning of twenty-first century, and many peptides were synthesized and are used as active ingredients in cosmeceuticals. Most of these peptides are oriented towards the treatment of skin aging, mainly for the attenuation of fine lines and wrinkles. Others are positioned in the management of hyperpigmentation or may also be antimicrobial peptides. Finally, peptides also exist which can improve hair growth. Formulation of peptides in cosmeceuticals is relatively easy, however attention must be paid to their transcutaneous penetration. For small-sized peptides there is usually no problem, whilst for bigger-sized peptides various artefacts like encapsulation or branching with fatty acids must be used. Another concern about peptides is their eventual toxicity, and there is currently insufficient responses from the industry about this matter.The majority of research studies are focused on the development of anti-aging actives, and there is still room for research to be carried out to evaluate other functions of these actives and create new actives for other indications. Understanding of cellular mechanisms, gene regulation, receptor activity and metabolic interactions increases constantly and many more peptides will probably appear and have applications in cosmeceuticals.

Management of Hyperpigmentation in Darker Racial Ethnic Groups

Dyschromias, in particular hyperpigmentation, are major issues of concern for people of color. Pigmentary disorders such as melasma and postinflammatory hyperpigmentation (PIH) can cause psychological and emotional distress and can pose a negative impact on a person's health-related quality of life. The precise etiology of these conditions is unknown. Therapies for melasma and PIH target various points during the cycle of melanin production and degradation. Therapies for these conditions include topical agents and resurfacing procedures. Hydroquinone remains the gold standard of topical agents. Other efficacious agents include kojic acid, azelaic acid, mequinol, and retinoids. Cosmeceutical agents include licorice, arbutin, soy, N-acetyl glucosamine, and niacinamide. Resurfacing procedures that have been used to treat melasma and PIH include chemical peels, microdermabrasion, lasers, and intense pulsed light. These procedures are best used in combination with topical bleaching agents. Given the propensity of darker skin to hyperpigment, resurfacing procedures should be used with care and caution. Maximal results are best achieved with repetitive, superficial, resurfacing modalities. In addition, ultraviolet protective measures such as broad-spectrum sunscreens are fundamental to the successful management of these conditions.