Updates in Pigmentary Disorders

On the final day of Spring Dermatology Week 2024, Susan Taylor, MD, FAAD, discussed management approaches to melasma and pigmentary disorders, offering insights into mechanisms, treatments, and emerging therapies during her session, “Management Approach to Melasma/Pigmentary Disorders.”

Melasma, characterized by symmetrical hyperpigmented patches, and post-inflammatory hyperpigmentation were primary focuses. Dr Taylor emphasized understanding the mechanisms of dyschromias, including melanogenesis pathways and factors inciting pigmentation.

Various interventions were explored, ranging from topical and systemic agents to procedural therapies. Cosmetic camouflage and photoprotection, especially against visible light, were underscored as being crucial in dyschromia management. Studies highlight the efficacy of sunscreens containing iron oxide or antioxidants, demonstrating significant improvements in pigmented spots and skin radiance.

Triple combination creams, featuring tretinoin, hydroquinone, and fluocinolone acetonide, stand out as gold standards in melasma treatment. Cosmeceutical agents like cysteamine and methyl resorcinol show promise in treating melasma and post-inflammatory hyperpigmentation. Oral tranexamic acid emerges as a potential therapy, although caution is advised due to possible adverse effects.

Procedural treatments such as laser therapy and chemical peels offer additional options, with studies showing notable improvements in pigmentation scores. Laser-assisted drug delivery enhances topical medication efficacy while minimizing systemic side effects. Notably, combination approaches yield superior outcomes, exemplifying the synergy between topical agents and procedures.

Beyond melasma, Dr Taylor discussed treatments for lichen planus pigmentosus, confluent and reticulated papillomatosis, erythema dyschromicum perstans, and minocycline-induced pigmentation. Therapeutic modalities include topical creams, oral medications, laser therapy, and chemical peels, each tailored to the specific disorder.

In conclusion, Dr Taylor emphasized comprehensive management strategies that prioritize sun protection, utilize topical and systemic agents, and integrate procedural interventions. Multimodal approaches offer effective solutions for diverse pigmentary disorders, emphasizing patient-centered care and improved quality of life.

For more meeting coverage, visit the Spring Dermatology Week 2024 newsroom.

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Reference
Taylor S. Management approach to melasma/pigmentary disorders. Presented at: Dermatology Week; May 8–11, 2024; Virtual.