Conclusion: The combination of fractional resurfacing, topical bimatoprost, and tretinoin or pimecrolimus is a potential effective resource for the treatment of hypopigmented scars, with long-lasting results.
Tretinoin is considered the gold standard topical (applied to the skin) treatment, as it's the only ingredient that's been studied and examined for the treatment of white spots from sun damage.
Topical ointments like TriLuma and Hydroquinone are very effective against hypopigmentation. They help to even out the skin tone by bleaching the entire skin surface. Ginger is known to have excellent effects against hypopigmentation.
Retinol & ascorbic acid can help build collagen & reduce unwanted pigmentation. Vitamin E & ferulic acid can act as antioxidants, reducing UV induced collagen loss.
That's because tretinoin is sometimes prescribed off-label to treat dark spots or melasma. In these cases, lightening the skin spots is the goal. But other times, tretinoin may cause too much lightening (hypopigmentation) or darkening (hyperpigmentation) of your skin.
Hypopigmentation may improve or go away on its own. If a skin condition causes hypopigmentation, medications may help restore color to your skin. If you have a genetic condition, hypopigmentation may be permanent. Be sure to use sunscreen on your light patches of skin.
Tretinoin also decreased the epidermal melanin content of normal skin more than the vehicle did (an 11 percent decrease vs. a 22 percent increase; P = 0.07).
Currently, several vitamins and supplements are being investigated for their ability to boost melanin production. However, the best way to support melanin production and good skin health is to eat a healthy diet full of vegetables, fruit, and whole grains.
Usually, pigmentation returns gradually. Patients need to understand that this process takes months, and sometimes longer. However, if the damage has been severe, the hypopigmentation may be permanent. Repigmentation, if it occurs, takes months and, sometimes, years.
Ruxolitinib (Opzelura): This topical JAK inhibitor is the first FDA-approved treatment for vitiligo. Applied directly to the affected areas, it offers a targeted approach with potentially fewer side effects compared to oral JAK inhibitors.
Using bimatoprost 0.03% solution alone without invasive adjunctive therapies is not only more tolerable from a pain perspective but is also a more cost-effective, one-step option for patients looking to improve scar appearance in hypopigmented scars.
Rolling scars
Tretinoin may be the most effective for atrophic scars as it works by stimulating collagen production and promoting skin cell turnover, which can gradually improve the appearance of these scars6. It can help smoothen the skin and fill in some of the depressions over time.
The skin will be more prone to sunburn, dryness, or irritation, especially during the first 2 or 3 weeks. However, you should not stop using this medicine unless the skin irritation becomes too severe.
The combination of tretinoin and hydroquinone cream is considered one of the best treatments for hyperpigmentation and melasma. It is also effective for post-inflammatory hyperpigmentation from acne, eczema, and psoriasis.
Macular hypomelanosis and idiopathic guttate hypomelanosis are probably related disorders along a spectrum of depigmentation. Treatment with tretinoin for 4 months restored the elasticity, the glyphic markings, with a partial restoration of pigmentation.
This was driven by concerns over skin irritation and systemic absorption. These could pose health risks, particularly in vulnerable populations such as pregnant women. The ban reflects a broader precautionary approach by the EU.
Retinoids have been implicated in causing mild-to-moderate elevations in routine liver tests, but these elevations are usually asymptomatic and transient, resolving spontaneously even with continued therapy.
If no new symptoms develop and you manage the underlying problem, the lighter areas will fade. In most cases, it takes at least several months, even a year, to resolve. Usually, no treatment is necessary if post-inflammatory hypopigmentation is a temporary problem. Sometimes, creams can boost the healing process.
After three months, 94 percent of the patients experienced a significant decrease in the depth of their acne scars. The researchers concluded that tretinoin is an “effective, noninvasive treatment of atrophic acne scars without causing disturbing side-effects.”
At-home Treatments
Supplements such as vitamin D3 can help to repigment the affected areas but again, this isn't a fail-safe treatment. Sufferers should also try to avoid stress as much as possible to help naturally increase Vitamin D3 levels”.
Topical corticosteroids - Low dose corticosteroids are used as first-line drugs in many hypopigmented conditions. They are known to accelerate the repigmentation process. Their use, along with phototherapy, also has great outcomes.
White & Hypopigmented Scars
They can be challenging to treat. The focus is to get your pigment cells to produce more melanin. Lasers, topicals, microneedling & melanocyte surgical transfer are methods to achieve this. The highest success is seen in autologous surgical melanocyte transfer via micrografting.
Treatment. The best treatments for this condition are topical corticosteroids or tars, light or laser treatment, or surgical skin grafting. We can treat hypopigmentation naturally by using strong sunblock, gentle exfoliation, apple cider vinegar, vitamin C, green tea, liquorice extract, and aloe vera.