Kosmed Med 2014 (35)2: 60-69

Melasma and Post-Inflammatory Hyperpigmentation (PIH): A Review Article

Omar M. Alakloby,1 Fatimah M. Budair2

1Professor, University of Dammam, College of Medicine; Department of Dermatology, Saudi Arabia

2Assistant Professor, University of Dammam, College of Medicine; Department of Dermatology, Saudi Arabia

Key words: Melasma, post-inflammatory hyperpigmentation, laser, peels, skin whitener

 

Summary:
Melasma is a common hyperpigmentary disorder that commonly affects sun exposed skin, especially the face. It is more common in females, and its exact causes are not well known.
Post-inflammatory hyperpigmentation (PIH) can follow a tremendous number of inflammatory skin diseases.
Various treatment modalities can be used to treat melasma including skin whitening agents, skin peeling, and laser. Chemical whitening agents have been used in dermatology since the early sixties of the last century. They can be used to treat melasma and PIH with variable responses, depending on the level of pigmentation. Each hypopigmenting agent has its own mechanism of action. The most famous agent is Hydroquinone (HQ) which, acts by inhibiting tyrosinase enzyme. Other agents include Kojic Acid and Azelic acid wich have more or less a similar mode of action. Despite their important rules in reducing skin pigmentation these chemicals are not without adverse effects that should be entertained before their uses. As opposed to PIH a good number of patients with melasma will have a recurrence after treatment discontinuation. Dermatologists should be familiar with the various types of hyperpigmentation and their management.