Combination of In-Office Chemical Peels With a Topical Comprehensive Pigmentation Control Product in Skin of Color Subjects With Facial Hyperpigmentation
April 2017 | Volume 16 | Issue 4 | Original Article | 301 | Copyright © 2017
Jeanine Downie MD, a Katie Schneider BS, b Lisa Goberdhan BA, b Elizabeth T. Makino BS CCRA MBA, b and Rahul C. Mehta PhD b
aImage Dermatology, Montclair, NJ bSkinMedica, Inc., an Allergan Company, Irvine, CA
Dyschromia is one of the primary complaints for patients with skin of color. Treatments need to achieve a balance between tolerability and efficacy to address existing hyperpigmentation without causing additional damage that could trigger post-inflammatory hyperpigmentation (PIH). An open-label, single-center study was conducted to assess the efficacy of a novel comprehensive pigmentation control serum (LYT2) combined with a series of three very superficial chemical peels (VP) in skin of color subjects. Seventeen female and male subjects aged 36 to 69 years with Fitzpatrick Skin Types III-VI and moderate to severe facial hyperpigmentation were enrolled in the 12-week clinical study. Subjects identified as Asian, Hispanic, African American, or Caucasian ethnicities. Subjects received a series of 3 VP treatments every 4 weeks. LYT2 was applied twice-daily in between VP treatments. Investigator assessments for overall hyperpigmentation, overall photodamage, and skin tone unevenness, as well as standardized digital photography and subject self-assessment questionnaires were conducted at all visits (baseline and weeks 4, 8, and 12). In vivo reflectance confocal microscopy (RCM) of a target lesion was conducted (in a subset of subjects) at baseline and week 12. Fourteen subjects completed the study. The treatment regimen provided statistically significant improvements in all efficacy parameters at weeks 8 and 12 (all P less than equal to 0.03, student’s t-test). Standardized digital photography and RCM images support the improvements in overall hyperpigmentation observed by the investigator. At the end of treatment, the regimen was highly rated by subjects with 100% of subjects (strongly agree/agree) that the combination “decreased the appearance of uneven skin tone and discolorations” and “reduced the appearance of sun damage.” In addition to this clinical study, independent case studies with this combination treatment regimen at a separate study site were also conducted with results that corroborate the formal clinical study findings. The comprehensive results from these studies suggest that the combination of a comprehensive pigmentation control serum with a series of 3 very superficial chemical peels may provide an effective treatment approach for hyperpigmentation in skin of color patients.
J Drugs Dermatol. 2017;16(4):301-306.
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Skin dyschromias and in particular hyperchromia or hyperpigmentation is a common concern amongst patients of all skin types and can negatively impact their quality of life.6 Ethnic skin, also called skin of color, categorized as Fitzpatrick Skin Types IV to VI and sometimes including Type III, typically refers to persons of African, Asian, Middle-Eastern, or Hispanic descent.6,7,9,12 It is predicted by the U.S. census bureau that by 2050, approximately half of the population in the United Sates will be persons with skin of color and Caucasians will become the minority.1,2,7,9,11 Cosmetic procedures have been increasingly popular in persons with skin of color accounting for over 20% of cosmetic procedures within the United States.1,3 As this number is growing, it is important to understand the biological differences in skin of color patients and the available treatment options in order to provide optimal outcomes. Dyschromia is one of the primary complaints to dermatologists from persons with skin of color.6,12 Pigmentation disorders such as post-inflammatory hyperpigmentation (PIH) are more prevalent in persons with skin of color compared to Caucasians.3,8 Although darker skin types have natural photoprotection, they are predisposed to a higher risk of PIH after injury due to increased melanocytic activity making treatment options challenging.1,11,12 Treatments need to achieve a balance between tolerability and efficacy in order to address existing hyperpigmentation without causing additional damage that could trigger PIH.