Experience with a Strong Bleaching Treatment for Skin Hyperpigmentation in Orientals

Abstract

Although a variety of topical treatments have been used for skin hyperpigmentation, the effectiveness of each varies after prolonged treatment. In this study, 136 Oriental patients who were followed up for more than 12 weeks were analyzed. The treatment protocol was composed of two steps: bleaching (2 to 6 weeks) and healing (2 to 6 weeks); 0.1% to 0.4% all-trans retinoic acid aqueous gel was originally prepared and applied concomitantly with hydroquinone-lactic acid ointment for bleaching. After obtaining sufficient improvement of the hyperpigmentation, a corticosteroid was applied topically with hydroquinone and ascorbic acid for healing. Improvement was evaluated with a narrow-band reflectance spectrophotometer. The results were successful in more than 80 percent of cases of senile lentigines and postinflammatory hyperpigmentations, especially on the face. Sixty percent of cases of nevus spilus were also successfully treated. Although the transient adverse effects of this treatment may be more severe than conventional treatment, this strong bleaching protocol improves a variety of hyperpigmented lesions, including nevus spilus, with a higher success rate and a shorter treatment period than conventional protocols.

Treatment of melasma

“…20 Included in this group were 6 patients who needed a second course of treatment. Erythema and scaling were observed during treatment.…”

Treatment of solar lentigines

“…33 HQ was applied to skin lesions twice daily for several weeks before combination treatment with RA plus HQ twice daily. The concentration of RA used depended on location of the lesion; 0.1% RA was used on the face, 0.2% on the trunk, and 0.4% on the lower extremities.…”

Combined Therapy Using Q-Switched Ruby Laser and Bleaching Treatment with Tretinoin and Hydroquinone for Periorbital Skin Hyperpigmentation in Asians

“…This bias reflects the Japanese tendency to dislike the dark skin color under the eyes rather than that of the upper skin color. Plastic and Reconstructive Surgery • January 2008 Yoshimura et al 6,10 previously described an aggressive and optimal use of tretinoin along with hydroquinone for various types of skin hyperpigmentation in Asians. This topical bleaching treatment proved to be very effective in epidermal pigmentation removal.…”