Pigmentary Disorders Articles
Acute Onset Linear Lichen Planus Pigmentosus of the Forehead: A Case Series
Linear lichen planus pigmentosus (LPP) of the face is a rare variant of lichen planus, with only a few cases published in the literature.1 It is an inflammatory condition with unknown etiology, characterized by blue-gray hyperpigmented macules, and tends to affect sun-exposed areas of the head and neck.1-4
Examining the Potential for Koebnerization and Disease Precipitation in Cicatricial Alopecias
The treatment of primary scarring alopecias is challenging and patients may be susceptible to koebnerization. This predisposes cicatricial alopecia patients to worsening of their disease following procedural treatments or interventions.
Refractory Alopecia Areata and Vitiligo Responding to Tofacitinib Monotherapy
Background: Hydroquinone is effective in melasma treatment, but side effects may limit its use. Silymarin cream may be a safer alternative. Objective: To compare the efficacy of 1.4% silymarin with 2% hydroquinone for melasma treatment in Asians.
A Randomized, Double-Blind, Split-Face Study of Topical Silymarin vs 2% Hydroquinone Cream in Melasmas
Background: Hydroquinone is effective in melasma treatment, but side effects may limit its use. Silymarin cream may be a safer alternative. Objective: To compare the efficacy of 1.4% silymarin with 2% hydroquinone for melasma treatment in Asians.
Topical Stabilized Cysteamine as a New Treatment for Hyperpigmentation Disorders: Melasma, Post-Inflammatory Hyperpigmentation, and Lentigines
Cysteamine is an aminothiol naturally present in cells of the human body as an antioxidant resulting from the degradation of Coenzyme A. Physiologically it is well distributed in mammalian tissues. Highly concentrated in human milk, cysteamine acts as an intrinsic antioxidant and is known for its protective role. Multiple studies now document that cysteamine is a potent skin depigmenting agent.
Examining the Potential for Koebnerization and Disease Precipitation in Cicatricial Alopecias
Lauren Fried MDa*, Melissa R. Laughter MD PhDb*, Katerina Svigos MDa, Avani M. Kolla MDa, Daniel Gutierrez MDa, Jerry Shapiro MDa*, Prince Adotama MDa**, Kristen Lo Sicco MDa** J Drugs Dermatol. 2023;22(1):29-34. doi:10.36849/JDD.6849
The treatment of primary scarring alopecias is challenging and patients may be susceptible to koebnerization. This predisposes cicatricial alopecia patients to worsening of their disease following procedural treatments or interventions. Research and recommendations surrounding the risk for koebnerization within scarring alopecias is extremely limited. Using a comprehensive literature review, we summarized the risks of procedures in potentially koebnerizing alopecias.
Clinical Evidence of Cell-Targeted Topical Therapy for Treating Skin Dyspigmentation
New development of cell-targeted therapies to enable site-specific skin tissue drug delivery may reduce off-target effects, decrease unwanted toxicities, and enhance drug efficacy. These efforts have led to several targeting strategies that modulate active product delivery to include small molecule-, nucleic acid-, peptide-, antibody-, and cell-based strategies. Tissue specific cell-targeting strategies such as these may be useful in cosmetic dermatologic applications.
New Protocol for Long-Term Results With a Multi-Pulse Nd:YAG Laser for Melasma Treatment: A Descriptive Cohort Study
Melasma is a photoaging condition with a typical clinical and histological pattern under a genetic and epigenetic context. Over the years, many treatments modalities have been proposed including topical agents, oral medication, procedures, and combination treatments aiming at different aspects of the pathogenesis including photodamage, inflammation, vascularity, and pigmentation. Recently, lasers have become an alternative for the treatment of melasma using thermal energy to target, in a selective way, the chromophore found in the skin such as melanin
The Therapeutic Use of Antioxidants for Melasma
Melasma is a chronic and acquired skin disorder of hyperpigmentation that presents with symmetric hypermelanosis of sun exposed areas, especially the face. Disease prevalence, ranging from 1 to 50%, varies with gender, ethnicity, skin phenotype, and sun exposure.1
The pathogenesis of melasma is incompletely understood, which poses a challenge for disease management. Causative factors include genetics, ultraviolet (UV) radiation, cosmetics, pregnancy, hormonal therapy, phototoxic drugs, and various medications.1,2
Post-Inflammatory Hyperpigmentation: A Review of Treatment Strategies
Post-inflammatory hyperpigmentation (PIH) is a reactive process resulting from increased melanin or abnormal distribution of melanin secondary to inflammatory skin conditions, dermatologic therapies, and external stimuli. Because PIH is a common condition that has a substantial effect on the quality of life, an understanding of its treatment modalities is essential. Though there are many therapeutic strategies for hyperpigmentary conditions such as melasma that are described in the literature, fewer studies focus on PIH. This article aims to provide a comprehensive literature review of therapies specifically used to treat PIH, such as topical combinations, chemical peels, and lasers.
The Use of Botanical Extracts in East Asia for Treatment of Hyperpigmentation: An Evidenced-Based Review
Recent years have seen a growth in the Asian cosmeceutical industry and an expanding worldwide marketplace with increasing consumer use of plant-based skin care products. The rising prevalence of Asian cosmeceuticals has led to research studies assessing the safety and efficacy of these products. We seek to review current evidence on safety and efficacy of key ingredients used in Asian cosmeceuticals to treat disorders of hyperpigmentation. A comprehensive search on PubMed was conducted to identify hyperpigmentation-related research studies on eight popular ingredients used in Asian cosmeceuticals: green tea, soy, orchid, licorice, rice water, ginseng, bamboo, and aloe. Both in vitro studies and clinical trials involving human subjects were included. Of the ingredients reviewed, soy and licorice had the most clinical evidence supporting their efficacy, while all other ingredients were supported by in vitro studies. More research is needed to further evaluate the safety and efficacy of Asian cosmeceutical ingredients in treatment of hyperpigmentation.
Impact of Iron-Oxide Containing Formulations Against Visible Light-Induced Skin Pigmentation in Skin of Color Individuals
Visible light (400–700nm), which contributes to 45% of solar radiation, contributes to skin darkening and worsening of dyschromias, particularly in individuals with Fitzpatrick skin phototypes III and higher. Currently, sunscreens provide limited protection against that spectrum. Due to their capabilities in absorbing, scattering, and reflecting visible light, topical products containing pigments and/or metal oxides can provide additional photoprotection. In this study, the efficacy of two formulations containing iron oxide was evaluated in preventing visible light-induced pigmentation compared with a non-tinted mineral SPF 50+ sunscreen. Expert grading and colorimetry demonstrated that the iron-oxide containing formulations significantly protected against visible light-induced pigmentation compared to untreated skin or mineral SPF 50+ sunscreen in Fitzpatrick IV individuals. These results highlight that iron-oxide containing formulas in a foundation format have dual functions and can provide additional benefits in patients’ daily routine by masking existing pigmentation and preventing the development of pigmentation triggered by sunlight exposure, extending protection beyond UV spectrum.
Melasma’s Impact on Quality of Life
Melasma is a commonly acquired condition that mostly affects women with Fitzpatrick skin types III-VI with prominent brown pigmentation with or without an underlying erythema. Despite multiple treatment options, melasma can be challenging given its chronic and relapsing nature. The objective of this article is to review the quality of life impact of melasma and offer suggestions for enhancing the melasma specific quality of life scale.
Q-Switched 1064 nm Nd:YAG Laser in Treating Axillary Hyperpigmentation in Filipino Women With Skin Types IV-V
Post inflammatory hyperpigmentation (PIH) is an acquired hyper-melanosis typically arising following inflammatory lesions. It is one of the most common dermatologic complaints, which may develop in all skin types, however, higher prevalence is seen in patients with Fitzpatrick skin types IV-VI. The etiology underlying PIH can either be an exogenous source (allergy, irritation, contact dermatitis, dermabrasion, laser therapy or burns), an endogenous factor (primary inflammatory or bullous dermatosis) or even induced by an infectious agent such as herpes zoster virus infection. Morphologic pattern and degree of pigmentation vary depending on causative factors and melanin distribution in the epidermis, dermis or both.
Oral Polypodium Leucotomos Extract and Its Impact on Visible Light-Induced Pigmentation in Human Subjects
Clinical trial registration number: NCT02904798.
J Drugs Dermatol. 2019;18(12):1198-1203.
BACKGROUND: Visible light (VL) has multiple effects on the skin that currently available sunscreens do not protect against. Polypodium leucotomos extract (PLE) has properties that may offer protection against VL.
OBJECTIVES: To determine the effectiveness of PLE in preventing VL-induced effects.
Oral Polypodium Leucotomos Extract and Its Impact on Visible Light-Induced Pigmentation in Human Subjects
Clinical trial registration number: NCT02904798.
J Drugs Dermatol. 2019;18(12):1198-1203.
BACKGROUND: Visible light (VL) has multiple effects on the skin that currently available sunscreens do not protect against. Polypodium leucotomos extract (PLE) has properties that may offer protection against VL.
OBJECTIVES: To determine the effectiveness of PLE in preventing VL-induced effects.
