Document Detail

Management of facial hyperpigmentation.
MedLine Citation:
PMID:  11702317     Owner:  NLM     Status:  MEDLINE    
Facial and neck pigmentations are the most cosmetically important. They are common in middle-aged women, and are related to endogenous (hormones) and exogenous factors (such as use of cosmetics and perfumes, and exposure to sun radiation). Melasma (chloasma) is the most common cause of facial pigmentation, but there are many other forms such as Riehl's melanosis, poikiloderma of Civatte, erythrose peribuccale pigmentaire of Brocq, erythromelanosis follicularis of the face and neck, linea fusca, and cosmetic hyperpigmentations. Treatment of melasma and other facial pigmentations has always been challenging and discouraging. It is important to avoid exposure to the sun or to ultraviolet lamps, and to use broad-spectrum sunscreens. Several hypopigmenting agents have been used with differing results. Topical hydroquinone 2 to 4% alone or in combination with tretinoin 0.05 to 0.1% is an established treatment. Topical azelaic acid 15 to 20% can be as efficacious as hydroquinone, but is less of an irritant. Tretinoin is especially useful in treating hyperpigmentation of photoaged skin. Kojic acid, alone or in combination with glycolic acid or hydroquinone, has shown good results, due to its inhibitory action on tyrosinase. Chemical peels are useful to treat melasma: trichloroacetic acid, Jessner's solution, Unna's paste, alpha-hydroxy acid preparations, kojic acid, and salicyclic acid, alone or in various combinations have shown good results. In contrast, laser therapies have not produced completely satisfactory results, because they can induce hyperpigmentation and recurrences can occur. New laser approaches could be successful at clearing facial hyperpigmentation in the future.
A Pérez-Bernal; M A Muñoz-Pérez; F Camacho
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of clinical dermatology     Volume:  1     ISSN:  1175-0561     ISO Abbreviation:  Am J Clin Dermatol     Publication Date:    2000 Sep-Oct
Date Detail:
Created Date:  2001-11-12     Completed Date:  2002-07-16     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  100895290     Medline TA:  Am J Clin Dermatol     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  261-8     Citation Subset:  IM    
Department of Dermatology, Faculty of Medicine, Virgen Macarena Hospital, Seville, Spain.
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MeSH Terms
Facial Dermatoses / chemically induced,  therapy*
Hyperpigmentation / chemically induced,  therapy*

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