Prevention of Post-Inflammatory Hyperpigmentation in Skin of Colour: A Systematic Review

Post-inflammatory hyperpigmentation (PIH) impacts all skin tones with a heightened predilection for Fitzpatrick skin types (FST) III-VI. Preventative measures include pre- and post-intervention approaches, such as sunscreen and corticosteroids. This systematic review aims to summarise the preventative measure outcomes for skin of colour individuals.

A literature search was conducted using MEDLINE (from 1946) and Embase (from 1974) in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

Of 14 studies, 369 cases were included. The mean age was 38 years (n = 293) and 72% were female (n = 265). All patients were of Asian ethnicity, and 42% were of FST III, 54% FST IV, and 4% FST V. Nearly all cases were precipitated by laser therapy (> 95%), and the face was the most reported location (85%). The most successful preventative measure was sunscreen alone or combined with other ingredients. Less successful outcomes were seen with topical corticosteroids and systemic tranexamic acid, while cooling air devices exacerbated the development of PIH.

Overall, only sunscreen consistently prevented the incidence of PIH; however, the severity of the ensuing PIH may be diminished with other measures. There is considerable room for improved preventative strategies for at-risk populations.