Clinical Practice Insights for Hyperpigmentation Treatment

Hyperpigmentation disorders, a group of common skin conditions characterised by darkened patches due to excess melanin production, affect a significant portion of the global population, with women more frequently impacted than men. They are a leading reason for dermatology visits, particularly among people with skin of colour. Risk factors include genetic predisposition, medication use, and sun exposure, with visible light (VL) playing a significant role. While not physically harmful, the conditions, which include post-inflammatory hyperpigmentation (PIH), melasma, and solar lentigines (age spots) can lead to psychological distress and social stigmatisation. As such, they can have a significant impact on patients’ self-esteem and quality of life (QoL). Hyperpigmentation disorders are challenging to manage. Current treatments include over-the-counter and prescription oral and topical treatments, sunscreen, chemical peels, and laser therapy. However, all these treatments have limitations, and many are associated with side effects and complications, especially in darker skin tones. Hydroquinone, the gold standard of hyperpigmentation management for decades, for example, can cause erythema, desquamation, and a burning sensation, and longterm use of high-concentration hydroquinone can result in exogenous ochronosis. In addition, chemical peels and laser therapy can trigger both irritation and PIH. Isobutylamido-thiazolyl-resorcinol (Thiamidol), a tyrosinase inhibitor identified using recombinant human tyrosinase, is a promising addition to traditional treatments. It has shown efficacy in reducing hyperpigmentation with a good safety profile. As such, it has potential to enhance a holistic approach to hyperpigmentation disorder management. Here, Thierry Passeron, University Hospital of Nice, France; Ncoza Dlova, University of KwaZulu-Natal, Durban, South Africa; and Vasanop Vachiramon, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, talk about the evolving hyperpigmentation management landscape. They outline the impact, aetiology, pathophysiology, and current treatment approaches for hyperpigmentation disorders. They summarise the evidence base for Thiamidol and, reflecting on their own research and experience, they also explain how and why they are using the ingredient to enhance the management of hyperpigmentation in routine practice.