REVIEW ARTICLE BJD British Journal of Dermatology Facial hyperpigmentation: causes and treatment N.A. Vashi 1 and R.V. Kundu 2 1 Department of Dermatology, Boston University School of Medicine, Boston Medical Center, 609 Albany St J602, Boston, MA, 02118, U.S.A. 2 Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. St Clair Street Suite 1600, Chicago, IL,60611, U.S.A. Correspondence Neelam A. Vashi. E-mail: [email protected] Accepted for publication 11 June 2013 Funding sources This supplement was kindly sponsored by L’Or eal Research & Innovation and Beiersdorf. Conflicts of interest None declared DOI 10.1111/bjd.12536 Summary By midcentury, the U.S.A. will be more ethnically and racially diverse. Skin of colour will soon constitute nearly one-half of the U.S. population, and a full understanding of skin conditions that affect this group is of great importance. Structural and functional differences in the skin, as well as the influence of cul- tural practices, produce variances in skin disease and presentation based on skin type. In the skin of colour population, dyschromia is a growing concern, and a top chief complaint when patients present to the physician. A thorough under- standing of the aetiology and management strategies of facial hyperpigmentation is of importance in caring for those afflicted and also in the development of new therapies. What’s already known about this topic? • In the skin of colour population, facial hyperpigmentation is a common and grow- ing concern when presenting to the physician. • Facial hyperpigmentation can cause significant cosmetic disfigurement with subse- quent emotional impact. Therapy continues to be challenging as there is no univer- sally effective treatment. Existing agents have varying degrees of efficacy and potential risk of postinflammatory hyperpigmentation with different treatment pro- tocols. What does this study add? • Persons of colour will soon comprise a majority of the international and domestic populations. • A comprehensive knowledge and approach to assessment and treatment is necessary to care properly for skin of colour patients. • This review thoroughly discusses aetiologies of facial hyperpigmentation and cate- gorizes appropriate treatment strategies. Skin of colour, also known as ethnic skin, constitutes a wide range of racial and ethnic groups traditionally referring to persons of African, Asian, Native American, Middle Eastern and Hispanic backgrounds. By 2050, nearly one-half of the U.S. population will be nonwhite. 1 These skin types are generally categorized as Fitzpatrick types IV– VI, and are more richly pigmented. Structural and functional differences in the skin, as well as the influence of cultural practices, produce variances in skin disease, presentation and treatment based on skin type. Darker skin phenotypes are characterized by higher content of melanin, higher eumelanin to pheomelanin ratio, and more effective distri- bution of melanin for protection against ultraviolet (UV) radiation. 2 In skin of colour, the amount and epidermal distribution of melanin is an important biological feature. 3–5 Melanin is not a single compound; rather, it is a mixture of biopolymers syn- thesized by melanocytes located in the basal layer of the epi- dermis. 2 Based on their chemical composition, melanins are broadly classified into two types: eumelanin and pheomela- nin. 2 Multiple studies have reported that individuals with darker skin have higher total melanin content, and a higher amount of eumelanin than lighter-skinned individuals. 2 Furthermore, studies on cultured human melanocytes have © 2013 The Authors BJD © 2013 British Association of Dermatologists British Journal of Dermatology (2013) 169 (Suppl. 3), pp41–56 41
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Related Documents
