title: Hydroquinone therapy for post-inflammatory hyperpigmentation secondary to acne: not just prescribable by dermatologists.
abstract: Post-inflammatory hyperpigmentation after acne can be as troublesome as the acne itself. Hydroquinone, a tyrosinase inhibitor, in a 4% cream can be used safely twice daily for up to 6 months to treat post-inflammatory hyperpigmentation. The efficacy of this treatment can be enhanced by using a retinoid nightly and a mid-potent steroid, which is applied twice daily for 2 weeks, then at weekends only. Combination creams help with compliance, but often lack the strongest individual ingredients. Because steroids should not be applied to the face for prolonged periods, care should be taken when a hydroquinone cream containing a steroid is chosen. If post-inflammatory hyperpigmentation consists of a few lesions, spot therapy is useful. If post-inflammatory hyperpigmentation consists of many lesions, field therapy is favored. Safety concerns with hydroquinone consist only of occasional irritation, which can be suppressed with topical steroid or a short drug holiday. Physicians should feel comfortable to use hydroquinone without consulting a dermatologist. Key words: hydroquinone; acne; adolescent; post-inflammatory hyperpigmentation.
authors: Department of Dermatology, The Mount Sinai School of Medicine, New York, NY 10025, USA. mekhala.chandra@gmail.com
authors: Mekhala
authors: M
authors: Chandra
authors: Jacob
authors: J
authors: Levitt
authors: Cara A
authors: CA
authors: Pensabene
mesh_terms: D000152:Acne Vulgaris / Q000150:complications*; D057886:Bleaching Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006873:Hydroquinones / Q000009:adverse effects / Q000627:therapeutic use*; D017495:Hyperpigmentation / Q000188:drug therapy* / Q000209:etiology; D014442:Monophenol Monooxygenase / Q000037:antagonists & inhibitors*
chemical_list: D057886:Bleaching Agents; D006873:Hydroquinones; D014442:Monophenol Monooxygenase; C031927:hydroquinone