Hyperpigmentation in Skin of Color: What Works, What Hurts, and What’s New?

Hyperpigmentation—including melasma and post-inflammatory hyperpigmentation (PIH)—is one of the most common concerns among patients with skin of color. Treating pigment disorders safely requires a nuanced understanding of both skin biology and the latest therapeutic options.

Recent studies highlight the effectiveness of newer agents like cysteamine, tranexamic acid, and topical kojic acid derivatives. When used correctly, these ingredients can significantly reduce pigmentation without increasing irritation or rebound hyperpigmentation.

Effective Strategies for Treating Pigmentation:

• Avoid overuse of hydroquinone; consider drug holidays

• Daily sunscreen is essential for all skin tones

• In-office chemical peels and lasers must be tailored to darker skin types

• Topicals like cysteamine and TXA are gaining popularity

• Oral TXA is also a viable option for some

At Foxhall Dermatology, we offer safe, evidence-based pigment treatments designed specifically for patients with Fitzpatrick skin types IV–VI. Our priority is achieving clear, even skin tone without compromising skin health.

Author

Stephen Suah, MD, MS Stephen Suah, MD, MS is a board-certified dermatologist and the owner of Foxhall Dermatology, a premier medical, surgical, and cosmetic dermatology practice in Washington, DC.