salicylates and Hyperpigmentation

Chemical peeling is a common treatment in cosmetic dermatology. A peel that has been used for many years is trichloroacetic acid. Its adverse effects have for a long time been a major limitation. We present a practical review of the characteristics, mechanisms of action, indications, and complications of superficial chemical peels and of peeling with trichloroacetic acid.

Topics: Acids; Animals; Chemexfoliation; Collagen Type I; Drug Combinations; Elastin; Epidermis; Ethanol; Facial Dermatoses; Humans; Hyperpigmentation; Keratolytic Agents; Lactic Acid; Mice; Pigmentation Disorders; Precancerous Conditions; Resorcinols; Salicylates; Skin Aging; Skin Neoplasms; Trichloroacetic Acid

Postinflammatory hyperpigmentation (PIH) has posed a substantial challenge for patients with higher Fitzpatrick skin types, specifically types III to VI. Treatment modalities pose a number of limitations due to the number of treatments required, potential side effects, and overall efficacy. Fortunately, multiple therapies have been delineated that can be moderately to highly efficacious in treating PIH in patients with skin of color. This article will review some of these modalities and procedures for this common patient concern.

Topics: Chemexfoliation; Dermatitis; Dermatologic Agents; Dicarboxylic Acids; Drug Combinations; Ethanol; Glycolates; Humans; Hydroquinones; Hyperpigmentation; Inflammation; Keratolytic Agents; Lactic Acid; Pyrones; Resorcinols; Salicylates; Salicylic Acid; Skin Pigmentation; Tretinoin

Macular pigmentation of the tongue can be acquired following exposure to exogenous agents. Black lingual hyperpigmentation was observed during the full body skin examination of a man with a history of recurrent metastatic malignant melanoma. His tongue spontaneously returned to its normal pink color later that day. Bismuth subsalicylate (Pepto-Bismol) was suspected as the pigment-inducing agent; subsequently, re-challange with the antacid confirmed it to be the cause of his acquired, albeit transient, black tongue. The ingestion of medications, including other antacids, analgesics, antidepressants, antihypertensives and several antimicrobials has been associated with the development of acquired macular lingual pigmentation. In addition, hyperpigmentation of the tongue has been observed following the deposition of amalgam and the injection of local anesthesia or doxorubicin or interferon alpha and ribavirin. Also, inhalation of heroin and methaqualone vapors or tobacco has resulted in lingual hyperpigmentation. All of the patients with acquired macular lingual hyperpigmentation had tongues with a smooth surface without enlargement of the filiform papillae. Many of the individuals with hyperpigmented tongue had either black or dark skin color. The onset of tongue pigmentation varied from less than one day to several years after initial exposure to the associated exogenous agent. The color of the tongue usually returned to normal after the pigment-inducing agent was discontinued.

Topics: Bismuth; Humans; Hyperpigmentation; Male; Middle Aged; Organometallic Compounds; Salicylates; Tongue Diseases

Antibiotics and retinoids have been used for acne vulgaris for decades. Though effective, each has its own drawbacks. Chemical peels have been used for treatment of acne vulgaris with inadequate clinical evidence. We sought to determine the efficacy and safety of Jessner's solution (JS) in comparison with salicylic acid (SA) 30% in the management of acne vulgaris and postacne hyperpigmentation in patients with colored skin.. A total of 36 subjects (94.5% Fitzpatick Type IV-V) were recruited in this randomized double-blinded, split-face, controlled trial. Each side of the face was randomly assigned for treatment with either JS or SA. Subjects were treated once fortnightly for a total of three sessions. Lesion counting, Michaelsson acne score (MAS), photographs, and postacne hyperpigmentation index (PAHPI) were used to objectively assess the improvement. Complications were assessed during each visit. Statistical analysis was conducted using SPSS v22.0. Significance was set at P = 0.05.. At the end of therapy, significant reduction in inflammatory, noninflammatory lesions, MAS, and PAHPI scores (P < 0.001, respectively) were noted in comparison to baseline. Mixed model analysis revealed no significant outcome difference between the two groups. Patients who reported good and very good outcome were 76.4% (JS) and 85.3% (SA). Burning, stinging sensation, and exfoliation were the common complications reported. Postinflammatory hyperpigmentation was reported only once in the JS arm.. Both JS and SA were equally effective in the treatment of acne vulgaris and reducing postacne hyperpigmentation in patients with colored skin.

Topics: Acne Vulgaris; Adult; Chemexfoliation; Double-Blind Method; Drug Combinations; Ethanol; Facial Dermatoses; Female; Humans; Hyperpigmentation; Keratolytic Agents; Lactic Acid; Male; Pain; Resorcinols; Salicylates; Salicylic Acid; Severity of Illness Index; Skin Pigmentation; Treatment Outcome; Young Adult

Several chemical agents are currently used to perform superficial peels of the face to reduce facial hyperpigmentation and fine lines/wrinkles. Some of the most commonly used agents are alpha hydroxyl acids, such as glycolic acid (GA), or beta hydroxy acid, such as salicylic acid.. This study aims to compare the efficacy of GA to that of a novel derivative of salicylic acid, capryloyl salicylic acid (LHA).. In a split-face study, 50 female volunteers between the ages of 35 and 60 years with mild to moderate facial hyperpigmentation and fine lines/wrinkles were randomized and LHA or GA peel was applied to one side of the face. Increasing peel concentrations were applied (5-10% LHA or 20-50% GA) based on the tolerance level of the subjects and clinical observations of an expert dermatologist for 12 weeks at biweekly intervals.. Of the 44 volunteers who completed the study, at 12 weeks 41% of LHA-treated and 30% of GA-treated subjects demonstrated significant reduction of fine lines/wrinkles compared to baseline. Forty-six percent of LHA-treated subjects and 34% of GA-treated subjects showed significant reduction of hyperpigmentation compared to baseline. LHA treatment was better than GA peels, although there were no statistically significant differences between the two groups.. Five percent to 10% of LHA peel is generally safe and as effective as 20-50% GA peel in reducing facial hyperpigmentation and fine lines/wrinkles.

Topics: Administration, Cutaneous; Adult; Anti-Inflammatory Agents, Non-Steroidal; Chemexfoliation; Drug Therapy, Combination; Female; Glycolates; Humans; Hydroxy Acids; Hyperpigmentation; Keratolytic Agents; Middle Aged; Patient Satisfaction; Salicylates; Single-Blind Method; Skin Aging; Treatment Outcome

Topics: Aged; Female; Humans; Hyperpigmentation; Salicylates; Tongue Diseases; Tongue, Hairy

Topics: Administration, Cutaneous; Aged; Cosmetics; Dermatitis, Contact; Female; Humans; Hydroquinones; Hyperpigmentation; Patch Tests; Salicylates; Skin; Skin Cream; Skin Pigmentation; Sunscreening Agents; Treatment Outcome

Chemical peel and dermabrasion are traditional, well-proven methods for the rejuvenation of the skin. The medium-depth trichloroacetic acid peel and the deep phenol peel offer distinct advantages and disadvantages and are discussed in detail in this article. The management of complications associated with both peel techniques is also discussed. Regional dermabrasion is an effective adjunct to facial rejuvenative surgery, such as face lift and blepharoplasty. Full-face dermabrasion and spot or local dermabrasion are most often used in the treatment of facial scarring. The technique of dermabrasion is discussed as well as its indications and postoperative care. Results are shown for both dermabrasion and peel.

Topics: Administration, Topical; Chemexfoliation; Cicatrix, Hypertrophic; Dermabrasion; Dermatologic Surgical Procedures; Drug Combinations; Ethanol; Face; Herpes Simplex; Humans; Hyperpigmentation; Keratolytic Agents; Lactic Acid; Patient Selection; Phenols; Rejuvenation; Resorcinols; Salicylates; Skin; Skin Aging; Trichloroacetic Acid; Virus Activation