Retinoids and Azelaic Acid to Treat Acne and Hyperpigmentation in Skin of Color

By March 31, 2020SOC Manuscripts

There are increasing data describing the use of retinoid and azelaic acid use in skin of color for the treatment of both acne and the subsequent postinflammatory hyperpigmentation. Historically, some dermatologists have been hesitant to use retinoids in skin of color because of perceived hypersensitivity in this patient population. However, recent data support the use of retinoids and azelaic acid in skin of color as both safe and beneficial.

Tretinoin, tazarotene, and adapalene (ADA), have been successfully used to treat acne. These treatments are reviewed and their effectiveness in hyperpigmentation is discussed.

  1. Tazarotene for Postinflammatory Hyperpigmentation
    In a blinded, vehicle-controlled trial, 74 acne patients from darker racial ethnic groups (Fitzpatrick skin types IV to VI) were treated with once-daily application of tazarotene 0.1% cream.  Results showed significant reductions in overall post-inflammatory hyperpigmentation and dryness, erythema, burning, and peeling were mild in both patient groups studied.
  2. Adapalene for Acne in African American Patients An analysis of 5 trials were conducted assessing adapalene gel 0.1% for the efficacy of reduces acne lesions in African American patients.  Results showed adapalene 0.1% gel significantly reduced a greater number of inflammatory lesions among African American patients with Fitzpatrick skin types IV through VI. Adapalene may have better efficacy for inflammatory lesions in African Americans than in Caucasians and is a good choice for patients with skin of color.
  3. Adapalene for Postinflammatory Hyperpigmentation
  4. Adapalene/Benzoyl Peroxide and Tolerability in Skin of Color
  5. Benzoyl Peroxide/Clindamycin Plus Retinoid
  6. Clindamycin and Retinoid for Acne in Darker-Skinned Patients
  7. Azelaic Acid

To see the results of the remaining retinoids and azelaic acid, please read the free full-text at JDDOnline.com.

The full-text review article is available for free from the Journal of Drugs in Dermatology . The article was written by Heather C. Woolery-Lloyd MD, Jonette Keri MD, and Stefan Doig MD from the Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL.