Post-inflammatory Hyperpigmentation in Skin of Color: Emerging Therapies and Treatment Algorithms

Area of Science:

• Dermatology
• Pigmentary Disorders
• Medical Aesthetics

Background:

• Post-inflammatory hyperpigmentation (PIH) is a prevalent pigmentary disorder, particularly in individuals with skin of color.
• PIH can cause persistent lesions, leading to significant psychosocial distress.
• Optimized treatment strategies are crucial for diverse skin types affected by PIH.

Purpose of the Study:

• To review emerging therapies and treatment algorithms for PIH in adult and pediatric populations.
• To focus on evidence specific to skin of color for PIH management.
• To identify safe and effective treatment options beyond traditional therapies.

Main Methods:

• Comprehensive literature search from 2015-2025 for clinical studies on PIH interventions.
• Included randomized controlled trials (RCTs), cohort studies, case series, and case reports.
• Prioritized studies evaluating therapies in skin-of-color cohorts.

Main Results:

• Topical agents like cysteamine and tranexamic acid (TXA) show significant efficacy and safety in PIH treatment.
• Cysteamine 5% cream reduced hyperpigmentation within 16 weeks; topical TXA combinations improved pigmentation by 30-40%.
• Oral TXA and nutraceuticals show promise; procedural interventions require caution in darker skin.

Conclusions:

• Emerging therapies like cysteamine and TXA provide effective, safe alternatives for PIH in skin of color.
• Individualized, stepwise regimens integrating various treatments optimize PIH outcomes.
• Further research is needed for pediatric and skin-of-color populations to refine PIH treatment algorithms.