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. Main Benefits: Inhibits an enzyme necessary to produce melanin, helping to fade dark spots and discoloration. It also delivers some antioxidant protection. 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. Typically, it is the combination of treatments that offer the best results such as hydroquinone or azelaic acid and microdermabrasion. Length of treatment will depend on the cause and severity, as well as individual response. With that being said, it can take from 3–12 months to see significant improvements. Products to Treat Hyperpigmentation

Your doctor may also suggest laser treatment or chemical peels to reduce hyperpigmentation, depending on the cause of your hyperpigmentation. However, prolonged use of topical hydroquinone (without any breaks in use) can cause darkening of the skin, known as ochronosis. So it’s best to use topical hydroquinone only under the care of a dermatologist so that they can properly guide you on how to use the medication without any adverse effects. In one study, azelaic and glycolic acid creams were compared to hydroquinone in a 24-week clinical trial of dark-skinned individuals. Results showed this combination was just as effective as hydroquinone in treating hyperpigmentation, making it a suitable choice for skin of color. Microdermabrasion This skin type has a low propensity to burn as well as a very low incidence of cancer as a result of sun exposure. This is due to the role melanin plays in protecting the skin by absorbing and scattering energy from UV light. Works Well With: According to Nazarian, studies have shown that kojic acid works well with and enhances the effects of glycolic acid and hydroquinone.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/ Microneedling involves superficial piercing of the skin with tiny needles which create small wounds. As they heal, collagen and elastin production are stimulated which evens skin tone. In one study, researchers found that microneedling was a safe and effective treatment for hyperpigmentation and showed significant improvements at week 4. Update Day 2: I used the soap again all over my body for 3 minutes and on my face for 30 seconds. I am moisturising my face after each use and I am using sunscreen. In the evening, I noticed my face was stinging a little so I decided to skip the extra 30 seconds for my trouble areas and just did a 30 second wash on my face. In one clinical study niacinamide was shown to significantly decrease hyperpigmentation and increase skin lightness. Topical Corticosteroids on the Incidence of Postinflammatory Hyperpigmentation After QsNdYAG Laser. https://clinicaltrials.gov/ct2/show/NCT02492373

Singh A, Yadav S. Microneedling: Advances and widening horizons. Indian Dermatol Online J. 2016;7(4):244-254. doi:10.4103/2229-5178.185468 day review IN progress! I recently bought the Kojiesan soap for hyperpigmentation on my face such as around my mouth and on my forehead. As of today I have begun using it twice a day, and I intend to update for the next 2 weeks to see if there is any effect which is promised by the soap. And then after one month. Sarkar R, Bansal S, Garg VK. Chemical peels for melasma in dark-skinned patients. J Cutan Aesthet Surg. 2012;5(4):247-253. doi:10.4103/0974-2077.104912

Final Thought

Wu IB, Lambert C, Lotti TM, Hercogová J, Sintim-Damoa A, Schwartz RA. Melasma. G Ital Dermatol Venereol. 2012 Aug;147(4):413-8. https://pubmed.ncbi.nlm.nih.gov/23007216/ With this in mind, it is important to consult with your care provider before using hydroquinone and to follow all instructions carefully.

Licorice extract has glabridin, a chemical that has skin lightening properties and also prevents tyrosinase production, an enzyme that darkens the skin after sun exposure 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 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/ 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

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Kaufman BP, Aman T, Alexis AF. Postinflammatory Hyperpigmentation: Epidemiology, Clinical Presentation, Pathogenesis and Treatment. Am J Clin Dermatol. 2018 Aug;19(4):489-503. doi:10.1007/s40257-017-0333-6