Mind the Data Gap: Treating Acne-Induced Hyperpigmentation in Deep Skin Tones
Acne-induced macular hyperpigmentation (AMH) is a persistent and distressing concern for many patients with richly melanated skin, particularly those with Fitzpatrick Skin Types V and VI. Despite its prevalence and its emotional, social, and cosmetic toll, patients with darker skin tones remain underrepresented in clinical trials evaluating treatments for AMH.
A new scoping review in the June 2025 issue of JDD puts a spotlight on this glaring gap. The authors combed through existing studies and found a troubling trend: many trials either failed to report Fitzpatrick Skin Type data or simply did not include patients with skin of color. This lack of representation leaves dermatologists without the evidence they need to confidently recommend effective, safe, and tolerable treatment plans for the very populations who are most impacted.
The review calls for a more inclusive and standardized approach to research. Dermatologists are encouraged to routinely document patient FST, race, and ethnicity in both clinical care and study settings. Meanwhile, clinical trials must work intentionally to recruit more patients from underrepresented racial and ethnic groups. Until this becomes the norm, treatment strategies for AMH in patients with skin of color will continue to rely too heavily on extrapolated data—an approach that risks widening health disparities.
It’s a wake-up call for the field: if we want to effectively treat AMH in patients with skin of color, we need data that truly reflects them.
Citation: Smith CA, Hogeling M, Cheng CE. Treatment of acne-induced macular hyperpigmentation in Fitzpatrick skin types V to VI: a scoping review. J Drugs Dermatol. 2025;24(6):579-584. doi:10.36849/JDD.8703
