Further studies required on laser treatment for postinflammatory hyperpigmentation
Although certain laser treatments may be beneficial in postinflammatory hyperpigmentation, previous clinical studies have often lacked a quality level of evidence, according to a systematic review published in JAMA Dermatology.
Researchers conducted a systematic review by searching PubMed databases for published clinical studies examining the use of lasers for treating hyperpigmentation from Jan. 1, 1990, to May 31, 2016.
“The use of lasers for treating [postinflammatory hyperpigmentation] is a controversial topic lacking large randomized clinical trials,” the researchers wrote. “A number of other factors pose limitations in the reviewed clinical studies.”
Search terms included laser post-inflammatory hyperpigmentation, laser postinflammatory hyperpigmentation, and laser hyperpigmentation. Only English studies were included. Studies on postinflammatory hyperpigmentation of the mucosal surfaces and cases of hyperpigmentation believed to be secondary to hemosiderin deposition were excluded.
Of the 1,295 results, 20 studies with a total of 224 patients were included for review.
The researchers discovered a number of outstanding limitations to the studies reviewed. According to their review, none of the studies controlled for the intensity of normal pigmentation or used a validated scoring system for acne-induced postinflammatory hyperpigmentation. In most cases, diagnosis was not confirmed histologically. Several studies lacked control comparison groups or randomization. Concomitant use of other depigmenting agents was not controlled for in most cases. And in general, most cases involved postinflammatory hyperpigmentation refractory to other treatments, which the researchers noted may result in a selection bias for severe cases.
“Further studies including larger patient populations are indicated to fully characterize the clinical utility of laser treatments for postinflammatory hyperpigmentation,” the researchers concluded. – by Talitha Bennett
Disclosure: Agbai reports no relevant financial disclosures. Please see the full study for the other researchers’ relevant financial disclosures.