Hyperpigmentation: types, diagnostics and targeted treatment options

Pigment formation is highly complex. It is involved in inflammation, sun protection and many other processes. For practical purposes, such as exposure time for sun tanning, six skin types are distinguished according to Fitzpatrick, listed in decreasing lightness. The hyperpigmentation commonly occurs in Fitzpatrick skin types III to VI and can have a considerable impact on quality of life.

In this article we will give an overview of normal variations of pigmentation and the most often common pigment abnormalities. It also reviews diagnostics and the current targeted treatment options of epidermal and dermal pigmentation.

There are multiple hyperpigmented skin lesions, classification of pigmentation is based on histology or Woods light examination. Bleaching agents with phenolic compounds with non-phenolic agens as follow-up therapy appears to be the most beneficial treatment options for the hyperpigmentation.

The effective treatment of pigment disorders is characterized by influence of melanin formation, but the therapy should be based on a the correct diagnosis and always targeted to the other histopathological processes in the skin. The Woods light examination shows clinical aspect of the lesions and may be helpful in the determination of the diagnosis.