DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20214925

Expert opinion on current trends in hyperpigmentation management: Indian perspective

Sanjeev Kandhari, P. Narasimha Rao, Shehnaz Arsiwala, Anil Ganjoo, Seema Sood, Dinesh Kumar

Abstract


Hyperpigmentation is a common pigmentary disorder characterized by increased production of melanin. It is present in Asian skin phototypes, with a higher prevalence in the Indian population. Skin heterogeneity is seen in more than 80% of individuals of all age groups and genders in several cities across India. In children, the prevalence of hyperpigmentary disorders accounts for 1.54 per 1000 children.Sixty expert dermatologists participated in expert group meetings via teleconference webinar to elaborate on the current trends in the management of hyperpigmentary disorders. The major reasons for hyperpigmentary disorders in India include melanocyte function followed by exposure to ultraviolet radiation, race, ethnicity, use of medications, pregnancy, and use of cosmetic. There are wide varieties of skin-lightening or depigmenting agents and skin resurfacing procedures that aid in the management of hyperpigmentation. However, treatment becomes challenging due to compliance issues related to affordability, complexity of prescriptions, and treatment duration. Compliance increases only if the patient sees any improvement or discontinues treatment due to higher expectations. Hence, the success of the treatment lies in patient adherence. This article summarizes expert opinions on identifying, diagnosing, and managing hyperpigmentation with the help of topical depigmenting agents in the Indian scenario. It also emphasizes treatment adherence issues along with the role of patient counseling and education regarding disease awareness and treatment strategies.


Keywords


Hyperpigmentation, Pigmentary disorders, Photoprotection, Patient adherence

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References


Hyperpigmentation - American Osteopathic College of Dermatology (AOCD). 2020. Available at: https://www.aocd.org/page/Hyperpigmentation. Accessed on 19 August 2020.

Cestari T, Dantas L, Boza J. Acquired hyperpigmentations. An Bras Dermatol. 2014;89(1):11-25.

Nouveau S, Agrawal D, Kohli M, Bernerd F, Misra N, Nayak C. Skin hyperpigmentation in Indian population: Insights and best practice. Indian J Dermatol. 2016;61(5):487-95.

Fatima S, Braunberger T, Mohammad T, Kohli I, Hamzavi I. The role of sunscreen in melasma and postinflammatory hyperpigmentation. Indian J Dermatol. 2020;65(1):5-10.

Grimes P, Ijaz S, Nashawati R, Kwak D. New oral and topical approaches for the treatment of melasma. Int J Womens Dermatol. 2018;5(1):30-6.

Dogra S, Sarangal R. Pigmentary disorders: An insight. Pigment Int. 2014;1(1):5-7.

Hourblin V, Nouveau S, Roy N, de Lacharrière O. Skin complexion and pigmentary disorders in facial skin of 1204 women in 4 Indian cities. Indian J Dermatol Venereol Leprol. 2014;80:395-401.

Sori T, Jaisankar TJ, Thappa DM, Nath AK. Hyperpigmentary disorders in children: A hospital-based study in a tertiary care center. Indian Dermatol Online J. 2013;4(2):148-52.

Vashi N, Kundu R. Facial hyperpigmentation: causes and treatment. Br J Dermatol. 2013;169(3):41-56.

Ogbechie-Godec O, Elbuluk N. Melasma: an up-to-date comprehensive review. Dermatol Ther (Heidelb). 2017;7(3):305-18.

Scarcella G, Dethlefsen M, Nielsen M. Treatment of solar lentigines using a combination of picosecond laser and biophotonic treatment. Clin Case Rep. 2018;6(9):1868-70.

Larosa CL, Foulke GT, Feigenbaum DF, Cordoro KM, Zaenglein AL. Lentigines in resolving psoriatic plaques: rarely reported sequelae in pediatric cases. Pediatr Dermatol. 2015;32(3):114‐7.

Sarkar R, Das A. Periorbital hyperpigmentation: What lies beneath? Indian Dermatol Online J. 2018;9(4):229-30.

Adalatkhah H, Sadeghi-bazargani H, Amini-sani N, Zeynizadeh S. Melasma and its association with different types of nevi in women: a case–control study. BMC Dermatol. 2008;8:3.

Handel AC, Lima PB, Tonolli VM, Miot LDB, Miot HA. Risk factors for facial melasma in women: a case–control study. Br J Dermatol. 2014;171(3):588-94.

Patel A. Postinflammatory hyperpigmentation: Review of pathogenesis, prevention, and treatment. Pigment Int. 2014;1(2):59-69.

Verma S, Vasani R, Joshi R, Phiske M, Punjabi P, Toprani T. A descriptive study of facial acanthosis nigricans and its association with body mass index, waist circumference and insulin resistance using HOMA2 IR. Indian Dermatol Online J. 2016;7(6):498-503.

Hoffmann T, Corrêa-Fissmer M, Duarte C, Nazário R, Barranco A, Oliveira K. Prevalence of dermatological complaints in patients undergoing treatment for breast cancer. An Bras Dermatol. 2018;93(3):362-7.

Andrew P, Valiani S, MacIsaac J, Mithoowani H, Verma S. Tamoxifen-associated skin reactions in breast cancer patients: from case report to literature review. Breast Cancer Res Treat. 2014;148(1):1-5.

Basavaraj K, Seemanthini C, Rashmi R. Diet in dermatology: Present perspectives. Indian J Dermatol. 2010;55(3):205-10.

Li H, Fan L, Zhu S, Shin MK, Lu F, Qu J et al. Epilation induces hair and skin pigmentation through an EDN3/EDNRB-dependent regenerative response of melanocyte stem cells. Sci Rep. 2017;7(1):7272.

Sinha A, Yadav N, Madke B, Kar S. Prevalence of topical steroid misuse among rural masses. Indian J Dermatol. 2016;61(1):119.

Achar A, Rathi SK. Melasma: a clinico-epidemiological study of 312 cases. Indian J Dermatol. 2011;56(4):380-2.

Ghosh A, Das A, Sarkar R. Diffuse hyperpigmentation: A comprehensive approach. Pigment Int. 2018;5(1):4-13.

Hollinger J, Angra K, Halder R. Are natural ingredients effective in the management of hyperpigmentation? A systematic review. J Clin Aesthet Dermatol. 2018;11(2):28-37.

Baquié M, Kasraee B. Discrimination between cutaneous pigmentation and erythema: Comparison of the skin colorimeters dermacatch and mexameter. Skin Res Technol. 2014;20:218-27.

Callender VD, St Surin-Lord S, Davis EC, Maclin M. Postinflammatory hyperpigmentation: etiologic and therapeutic considerations. Am J Clin Dermatol. 2011;12(2):87-99.

Sahu P, Dayal S, Sangal B, Sharma S. Role of chemical peels in postinflammatory hyperpigmentation: a comprehensive review. Pigment Int. 2019;6(2):59-66.

Bae Y, Rettig S, Weiss E, Bernstein L, Geronemus R. Treatment of post‐inflammatory hyperpigmentation in patients with darker skin types using a low energy 1,927 nm non‐ablative fractional laser: A retrospective photographic review analysis. Lasers Surg Med. 2019;52(1):7-12.

Sarkar R, Ailawadi P, Garg S. Melasma in Men: A review of clinical, etiological, and management issues. J Clin Aesthet Dermatol. 2018;11(2):53-9.