INTRODUCTION
Hypopigmentation is a common cutaneous manifestation that frequently poses a therapeutic challenge for dermatologists. Hypopigmentation can generally be seen after surgery, laser procedures, trauma, or as a consequence of various inflammatory conditions. The pathogenesis of acquired hypopigmentation has been linked to inflammation, whereby various inflammatory factors cause suppression of pigmentation-related signaling, leading to decreased melanin production.1
Hypopigmentation can be a significant issue in patients with skin of color. In prior studies, it has been shown that many hypopigmented skin conditions may have inactive melanocytes that may be stimulated by various modalities to produce pigment.2 Presumably, the target is stimulation of the human epidermal melanocyte. Melanocytes are melanin-producing neural crest-derived cells located in the stratum basale. Once these cells are stimulated, they synthesize melanin in special organelles called melanosomes, which are transported to keratinocytes to induce pigmentation. The depth of the melanocyte depends on the patient skin site, but ranges from 20 micrometers to 141 micrometers (Table 1).3
Current treatment modalities for hypopigmentation include split thickness skin grafting, excisional surgery, exogenous pigment procedures (such as tattooing), dermabrasion, chemical peels, and laser therapy. However, current treatments have varying efficacies and rarely provide patients with long term results.
In the past decade, it has been shown that laser therapy may demonstrate improvement in hypopigmentation of acne and surgical scars. Fractional lasers were among the many devices studied to help improve hypopigmentation in acne and surgical scars. The mechanism of action is hypothesized to be the repopulation of melanocytes in the hypopigmented areas from surrounding hair follicle stem cells and basal melanocytes.4-7
Hypopigmentation can be a significant issue in patients with skin of color. In prior studies, it has been shown that many hypopigmented skin conditions may have inactive melanocytes that may be stimulated by various modalities to produce pigment.2 Presumably, the target is stimulation of the human epidermal melanocyte. Melanocytes are melanin-producing neural crest-derived cells located in the stratum basale. Once these cells are stimulated, they synthesize melanin in special organelles called melanosomes, which are transported to keratinocytes to induce pigmentation. The depth of the melanocyte depends on the patient skin site, but ranges from 20 micrometers to 141 micrometers (Table 1).3
Current treatment modalities for hypopigmentation include split thickness skin grafting, excisional surgery, exogenous pigment procedures (such as tattooing), dermabrasion, chemical peels, and laser therapy. However, current treatments have varying efficacies and rarely provide patients with long term results.
In the past decade, it has been shown that laser therapy may demonstrate improvement in hypopigmentation of acne and surgical scars. Fractional lasers were among the many devices studied to help improve hypopigmentation in acne and surgical scars. The mechanism of action is hypothesized to be the repopulation of melanocytes in the hypopigmented areas from surrounding hair follicle stem cells and basal melanocytes.4-7
