The treatment and management of acne and rosacea in patients with skin of color is associated with a unique set of challenges. Post-inflammatory hyperpigmentation (PIH) in particular remains one of the most challenging aspects of treatment. One key to optimal treatment is understanding how to best avoid this unwanted sequelae, according to Andrew F. Alexis, M.D., department of dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
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“The main challenge when treating patients with skin of color is PIH,” he says. “Particularly for acne vulgaris itself, PIH is a very common feature or sequela of the condition and it is often the driving force for the patient to go and see the dermatologist. It is my impression that the PIH is of equal and sometimes greater concern to the patient than the acne itself. Therefore as dermatologists, it is necessary to address both conditions when we interact with our patients.”
It is now widely accepted that inflammation and subclinical inflammation play a significant role in the development of lesions. Clinically, even non-inflamed lesions such as comedones still have inflammation that is subclinical. As such, Dr. Alexis says that there is a need to aggressively and effectively control the inflammatory component of the acne.