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Related Experiment Video

Updated: Oct 20, 2025

Using a 1064-nm Picosecond Neodymium-Doped Yttrium Aluminum Garnet Laser for Periorbital Hyperpigmentation
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Topical treatment for postinflammatory hyperpigmentation: a systematic review.

Marcus G Tan1, Whan B Kim1, Christine E Jo2

  • 1Division of Dermatology, The University of Ottawa, and The Ottawa Hospital, Ottawa, Canada.

The Journal of Dermatological Treatment
|September 16, 2021
PubMed
Summary

Topical treatments like retinoids and hydroxy acids are effective for postinflammatory hyperpigmentation (PIH). High-quality evidence supports their use, along with broad-spectrum sunscreens, for managing PIH.

Keywords:
Postinflammatory hyperpigmentationpostinflammatory hyperchromiapostinflammatory hypermelanosistopical treatment

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Area of Science:

  • Dermatology
  • Evidence-based medicine

Background:

  • Topical treatments are standard for postinflammatory hyperpigmentation (PIH).
  • Limited evaluation exists on the quality of evidence for topical PIH therapies.
  • This systematic review assesses the evidential quality of topical PIH treatments.

Purpose of the Study:

  • To systematically review and evaluate the evidence quality for topical treatments of postinflammatory hyperpigmentation (PIH).

Main Methods:

  • Systematic review of English-language studies on topical PIH medications.
  • Searches conducted in PubMed, MEDLINE, and EMBASE up to March 29, 2021.
  • Evidence quality assessed using the modified Grading of Recommendations, Assessment, Development and Evaluation (GRADE) scale.

Main Results:

  • Included 47 of 1,224 studies (1,853 subjects).
  • High-quality evidence supports retinoids, hydroxy acids, corticosteroids, thiamidol, niacinamide, and plant-derived products.
  • Broad-spectrum sunscreens (SPF30+) were consistently recommended; common side effects included skin peeling, burning, and dryness.

Conclusions:

  • Retinoids, hydroxy acids, and broad-spectrum sunscreens have the strongest high-quality evidence for PIH treatment.
  • An evidence-based algorithm for PIH management is proposed.
  • Validated outcome measures are needed for future PIH treatment comparisons.