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Hyperpigmentation treatment

• Treatment depends on whether the pigmentation is epidermal or dermal; epidermal pigmentation becomes accentuated with a Wood light or can be diagnosed with biopsy.
• Only epidermal pigmentation responds to treatment. First-line therapy, often effective, includes a combination of hydroquinone 2 to 4%, tretinoin 0.05 to 1%, and a class V to VII topical corticosteroid
• Hydroquinone 3 to 4% applied twice daily is usually required for long courses; 2% hydroquinone is useful as maintenance. Hydroquinone should be tested behind one ear or on a small patch on the forearm for 1 wk before use on the face because it may cause irritation or an allergic reaction.
• Azelaic acid 15 to 20% cream, can be used in place of or with hydroquinone and/or tretinoin. Hydroquinone, tretinoin, and azaleic acid are bleaching agents.
• IPL (Photofacial) - glycolic acid or 30 to 50% trichloroacetic acid is an option for patients with severe melasma Treatment with intense pulsed light, or a Photofacial, is frequently recommended by doctors to treat hyperpigmentation. However, improperly administered IPL treatment can make hyperpigmentation worse, so choose your doctor carefully.
• Chemical peel - A TCA peel or deeper phenol peel are also used to treat hyperpigmentation. Great care should be taken though as pigment irregularities and scarring can occur if not done by an experienced clinician with close follow-up.
• Laser peel - A variety of laser resurfacing treatments may be performed to reduce hyperpigmentation. CO2 lasers and fractional lasers are popular choices for skin resurfacing.

1. Sun exposure
2. Hormonal changes
3. Heredity
4. Acne
5. Botched skin treatments
6. In situations where hyperpigmentation is caused by acne, botched skin treatment, or some other cause of skin inflammation, it is known as PIH, or post-inflammatory hyperpigmentation.

• is the production of excess melanin causing dark spots on the skin. Age spots, liver spots, freckles, sun spots, pregnancy mask are all types of hyperpigmentation and there are several treatments available to reduce or remove the darker skin.
• Topical skin lightening products - Products containing skin lightening ingredients, such as hydroquinone, retinoids, kojic acid, and Vitamin C are often used to reduce hyperpigmentation.