Kooyers TJ, Westerhof W. Toxicologische aspecten en gezondheidsrisico’s van hydrochinon in huidbleekformuleringen [Toxicological aspects and health risks associated with hydroquinone in skin bleaching formula]. Ned Tijdschr Geneeskd. 2004 Apr 17;148(16):768-71. https://pubmed.ncbi.nlm.nih.gov/15129564/ Hyperpigmentation occurs when the skin overproduces melanocytes, melanin-producing cells that give skin its color. This increase in melanocyte activity has been shown to be stimulated by several inflammatory mediators that are released when inflammation occurs. This is true for all skin colors.

Prescription-strength options are another choice for those whose skin can tolerate them. They can provide faster results, and if you are under a dermatologist’s care, you would be well served as they can recommend combination therapy for greater efficacy. With this in mind, it is important to consult with your care provider before using hydroquinone and to follow all instructions carefully. Saeedi M, Eslamifar M, Khezri K. Kojic acid applications in cosmetic and pharmaceutical preparations. Biomed Pharmacother. 2019;110:582-593. doi:10.1016/j.biopha.2018.12.006In one clinical study niacinamide was shown to significantly decrease hyperpigmentation and increase skin lightness.

Singh A, Yadav S. Microneedling: Advances and widening horizons. Indian Dermatol Online J. 2016;7(4):244-254. doi:10.4103/2229-5178.185468 Phasha V, Senabe J, Ndzotoyi P, Okole B, Fouche G, Chuturgoon A. Review on the use of kojic acid—A skin-lightening ingredient. Cosmetics. 2022;9(3):64. doi:10.3390/cosmetics9030064 Hydroquinone is considered a mainstay treatment for hyperpigmentation and PIH as it provides strong results. It is a tyrosinase inhibitor that effectively inhibits new melanin formation. However, there is controversy surrounding this skin-bleaching agent as it can cause white patches as well as worsen existing pigmentation, in addition to some serious side effects.In one clinical trial, researchers found the incidence of PIH decreased by 40% after a topical corticosteroid was applied 2 days before and after ND:YAG laser treatment.

Your doctor may also suggest laser treatment or chemical peels to reduce hyperpigmentation, depending on the cause of your hyperpigmentation. A dermatologist can diagnose the cause of your hyperpigmentation. They will request your medical history and give you a physical exam to determine the cause. In some cases, a skin biopsy can narrow down the cause. Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. 2010;3(7):20-31. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921758/

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Home care also includes using sunscreen. Sunscreen is the single most important factor in improving most causes of hyperpigmentation. Look for: Callender VD, St Surin-Lord S, Davis EC, Maclin M. Postinflammatory hyperpigmentation: etiologic and therapeutic considerations. Am J Clin Dermatol. 2011 Apr 1;12(2):87-99. doi:10.2165/11536930-000000000-00000 Al Qarqaz F, Al-Yousef A. Skin microneedling for acne scars associated with pigmentation in patients with dark skin. J Cosmet Dermatol. 2018 Jun;17(3):390-395. doi:10.1111/jocd.12520 Geria AN, Lawson CN, Halder RM. Topical retinoids for pigmented skin. J Drugs Dermatol. 2011 May;10(5):483-9. https://pubmed.ncbi.nlm.nih.gov/21533293/