Facial hyperpigmentation is common and challenging to treat in darker-skinned populations. A Medline literature search of articles published up to October 2013 reporting the objective assessment of and/or treatment for melasma, postinflammatory hyperpigmentation, dermatosis papulosa nigra, lichen planus pigmentosus, and erythema dyschromicum perstans was reviewed. Objective assessment was only reported for melasma and postinflammatory hyperpigmentation. Furthermore, randomized controlled trial evidence was only reported for melasma. Although progress has been made, there is a need to develop more objective outcome measures and effective treatments for hyperpigmentation.
Key points
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Facial hyperpigmentation is common and disfiguring in people of African ancestry.
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Melasma is the most studied with validated severity scoring tools; however, combination treatments are often required to improve efficacy.
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More work is required to develop and validate severity scoring tools and to elucidate effective treatments for postinflammatory hyperpigmentation and lichen planus pigmentosus.
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