Topical bleaching chemicals can safely cure post-inflammatory hyperpigmentation in darker skin types as long as treatment is conservative and well monitored, claims Pearl E. Grimes, M.D., director of the Vitiligo and Pigmentation Institute of Southern California.
The gold standard for treating hyperpigmentation nowadays, according to Dr. Grimes, is “designer” bleaching products with 4% hydroquinone as the active ingredient; nevertheless, they can occasionally aggravate darker skin (Fitzpatrick types IV, V, and VI).
It doesn’t mean you can’t use these products, she insists; you can. Simply keep an eye on the patient and be mindful of any irritation.
Patients should be examined since thinner skin is more vulnerable to disruption.
Three topical medications to cure hyperpigmentation in people with darker skin Dr. Grimes gave Cosmetic Surgery Times details on three topical medications. Each one contains hydroquinone as well as several other active chemicals.
Instead of suggesting one bleach over another, she recommends practitioners get familiar with the most recent research on each bleach as well as the risk/benefit panel for each.
“Know the benefits and side consequences,” she recommends. Every item has some level of viability. Before you can declare one to be your favorite, you must first try them all.
In other circumstances, though, a different approach can be necessary.
“Possible ineffectiveness for severe post-inflammatory hyperpigmentation with any of these. You might still end up synthesizing bleach on the spot.”
Dr. Grimes routinely uses Tri-Luma Cream (Galderma) without a prescription to cure hyperpigmentation in patients with darker skin, despite the FDA has approved it as a combination bleach for the treatment of melasma. Tretinoin 0.05 percent, fluocinolone acetonide 0.01 percent, and hydroquinone 4% are all ingredients in Tri-Luma Cream.
“Tri-Luma Cream has become the main topical bleaching agent for hyperpigmentation,” she asserts. But, the worst error a doctor can do is to keep a patient on it indefinitely because it contains a fluorinated steroid.
If a patient’s condition does not improve after eight weeks—or 12 weeks in the event of a severe case—on Tri-Luma Cream, she will convert to another hydroquinone medication. If required, she brings the patient back to Tri-Luma Cream after a three-month break.
She continues, “The longer a patient uses Tri-Luma Cream, the greater the risk of atrophy, steroid-induced rosacea, or steroid-induced telangiectasia.”
Tri-Luma Cream is a fantastic option for hyperpigmentation because it works immediately.
Dr. Grimes claims that EpiQuin Micro (SkinMedica), which includes 0.15 percent retinol and 4% hydroquinone in a microsponge carrier, likewise yields effects swiftly.
According to Dr. Grimes, EpiQuin is an effective first-line medication for mild-to-moderate cases. It usually takes many months to remove post-inflammatory hyperpigmentation, so this is important, he says.
In a 12-week open-label research, she and her colleagues discovered EpiQuin to be secure and efficient. 25 participants applied the bleaching lotion to their full face once in the morning and once in the evening. 15 minutes after the morning application, they added sunscreen.