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Best Practices in the Treatment of Hyperpigmentation

By: Ahmed Abdullah, MD
Posted: April 27, 2012, from the May 2012 issue of Skin Inc. magazine.
professional skin care client with hyperpigmentation

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UV exposure. Questions surrounding these topics may pinpoint UV exposure as a cause of hyperpigmentation, while determining if the skin care professional should be on the lookout for signs of melanoma.

  • Use of tanning beds and unprotected UV exposure
  • Frequency of sunscreen usage
  • Likelihood of burning when exposed to the sun

Current and past medical conditions. There is a wide array of medical conditions that may contribute to hyperpigmentation, including Addison’s disease, Cushing’s disease and hypothyroidism.

Current or recent pregnancy, or current or recent use of birth control pills or hormone replacement therapies. Such questions may identify a hormonal cause of hyperpigmentation. If hyperpigmentation appears in a symmetrical, masklike manner, and the client confirms a hormonal cause, professionals can be nearly certain of melasma.

All oral and topical medications used within the past six months, and prescription and over-the-counter products used to specifically treat hyperpigmentation. Hyperpigmentation is a side effect of a number of medications, including certain antibiotics, cancer drugs, antiseizure drugs and more. Additionally, some topicals used in the treatment of hyperpigmentation, such as hydroquinone, have the potential to cause paradoxical hyperpigmentation.

Current or recent dermatological or plastic surgery consultations and treatments. When a medical professional is involved in the treatment of the client’s condition, it’s important that the client regularly communicate updates regarding prescriptions and diagnosis so the skin care professional can ensure the most appropriate treatment is being implemented. Some clients may choose to share a copy of their dermatological medical records with their esthetician.

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