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AAD Looks at Treatments for Conditions Targeting Those with Darker Skin Tones

Posted: September 30, 2009

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One of the most common pigmentation problems in darker-skinned individuals is hyperpigmentation, or the darkening of the skin. Usually the result of some type of inflammation or injury to the skin, such as a cut, burn or scrape, hyperpigmentation produces darkened areas of the skin that can last months or years. Even healed acne lesions can leave permanent dark spots in darker-skinned people that, in some cases, can be more distressing than the original acne.

Dr. Breadon noted that treatments for hyperpigmentation are based on whether or not the dark areas are confined to the surface of the skin or if they have penetrated to the deeper layers of the skin. For superficial dark spots, a prescription topical medication consisting of hydroquinone, retinoic acid and mild hydrocortisone can be effective in fading skin discoloration. Deeper dark areas require an in-office surgical procedure, such as dermabrasion, chemical peels or microdermabrasion with an infusion of hydroquinone solution. In patients with lighter skin, intense pulsed light (IPL) or one of the pigmented lasers could be considered.

“Patients with any type of hyperpigmentation problem need to use a sunscreen with a high sun protection factor (SPF) regularly—the higher SPF the better,” said Dr. Breadon. “There is no cure for this condition, so even when patients experience clearing, it can come back. For most patients, I usually recommend a three-month topical regimen, then long-term maintenance with a sunscreen.”

Melasma

Often referred to as the “mask of pregnancy,” melasma is a skin condition marked by brown patches on areas such as the face, neck and arms that most often affects dark-skinned people and women in particular. Many dermatologists have long believed that there may be a hormonal component to melasma, and a recently published study found that there were an increased number of estrogen receptors in areas where patients developed melasma.