RT Book, Section A1 Baumann, Leslie A1 Allemann, Inja Bogdan A2 Baumann, Leslie A2 Saghari, Sogol A2 Weisberg, Edmund SR Print(0) ID 1172447965 T1 Depigmenting Agents T2 Cosmetic Dermatology: Principles and Practice, 2e YR 2009 FD 2009 PB The McGraw-Hill Companies, Inc. PP New York, NY SN 9780071490627 LK dermatology.mhmedical.com/content.aspx?aid=1172447965 RD 2024/03/29 AB Hyperpigmented lesions, whether they are solar lentigos, freckles, or melasma, are the source of frequent complaints by cosmetic patients. In addition, some cosmetic patients develop postinflammatory hyperpigmentation after chemical peels, laser treatments, or even after a bout of acne. Melanin synthesis within melanosomes and their distribution to keratinocytes within the epidermal melanin unit determines skin pigmentation. Hyperpigmentation occurs when this system goes awry (see Chapter 13). But dark spots and patches are unacceptable to cosmetic patients. For this reason, there are hundreds of products on the market that are touted as “lightening creams.” Although there are many product choices available, the number of effective agents to treat hyperpigmentation disorders is relatively small. Unfortunately, most of these agents require months of use for improvement to be seen. Combination with retinoids (Chapter 30), sunscreens (Chapter 29), chemical peels (Chapter 20), and lights or lasers (Chapter 24) may enhance the effectiveness of these products. Currently available topical agents used to treat hyperpigmentation include tyrosinase inhibitors, melanosome-transfer inhibitors, melanocyte-cytotoxic agents, retinoids, peeling agents, and sunscreens. This chapter will discuss the ingredients commonly used for the treatment of pigmentary disorders.