Managing Hyperpigmentation: Treatment Approaches for Asian Skin


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Asian skin, characterized by a higher melanin content, provides inherent protection against
ultraviolet radiation compared to fair skin. However, this advantage comes with an increased
susceptibility to pigmentary disorders among Asians. Common abnormalities in this
demographic include lentigines, ephelides, melasma, post-inflammatory hyperpigmentation
(PIH), and nevus of Ota. Notably, melasma and PIH, due to their high recurrence rates, pose
significant challenges in management and adversely impact individuals’ quality of life.
The primary therapeutic approach involves targeting melanin synthesis pathways, employing
anti-inflammatory treatments, and reducing excess melanin. External treatments using
tyrosinase blockers, administered both before and after exposure to laser and light-based
technologies, prove effective in preventing active melanin synthesis in various forms of
hyperpigmentation. Oral tranexamic acid, at a dosage of 250 mg thrice daily for 3–4 months,
combined with antioxidant therapy, holds promise for treating melasma.
Non-ablative methods, such as Intense Pulsed Light (IPL) exposure, Q-Switched Nd: YAG, and
non-ablative fractional Er: Yag lasers, when used individually or in combination, target multiple
skin chromophores and enhance therapy effectiveness.
While light and laser technologies are pivotal for pigment removal, a comprehensive treatment
addressing the root causes is essential for lasting results, complication prevention, and
minimizing relapses. A combination approach, incorporating external agents, non-ablative laser
and light technologies, injection methods, oral tranexamic acid, and antioxidants, proves more
effective than monotherapy in achieving optimal results for ethnic skin.