Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete
-
Pigmentation disorders are a frequent skin problem and incorporate a broad spectrum of diseases, caused by an abnormal melanin pigmentation or also non-melanin pigmentation of the skin. Both hypermelanosis and hypomelanosis can be hereditary or acquired. This article summarizes the treatment approaches that are used in the majority of acquired pigmentation disorders of the skin. ⋯ For every disorder the specific dermatological treatment is presented even when some pigmentation alterations that occur in association with systemic diseases, are cured by the treatment of the primary disease. Most diseases are exacerbated by exposure to UV light. Therefore, sun protection is recommended and a cosmetic coverage is indicated.
-
Pigmentation disorders are among the most common cutaneous changes and occur in up to 60% of all people. They can be genetic or acquired, functionally or cosmetically disturbing, or the expression of a medical disorder. ⋯ A correct diagnosis is therefore essential, taking into account the skin type, the type of pigmentation and how deep the pigmentation is located in the skin. The most common indications for which laser treatment is recommended include genetically predisposed nevi (Becker, Ota, Hora, Ito, acquired bilateral nevus of Ota-like macules [ABNOM]), pigmentation (e.g., lentigines, postinflammatory hyperpigmentation, ephelides, café au lait, nevus spilus, linear and whorled hypermelanosis [LWNH]), nevus cell nevi, exogenous pigments, tattoos and cosmetic pigments.
-
Esthetically unattractive hyperpigmentation can occur post-inflammatory or as a result of genetic or hormonal influences, UV exposure or medication. Important parameters for the quality of topical treatments are evidence-based in vivo and in vitro efficacy as well as scientifically verified wanted and unwanted effects. ⋯ Hydroquinone is still the gold standard for the treatment of hyperpigmentation, along with the triple therapy of hydrochinon, tretinoin, and steroids in different modifications. In summary, hyperpigmentation is best treated using a combination therapy of different approaches that includes consequent UV protection.