Management of Hyperpigmentation in Keratitis Pilaris This is a very common(50-70%) ,chronic problem of dark skinned patients who not only suffer with bumpy dry skin like goose bumps(chicken skin)but in addition are afflicted with hyperpigmentation(darkening of skin) as well. It commonly affects the back & outer side of arms but can affect the whole body sparing only the hairless palms & soles of feet

This condition commonly runs in families where at least one parent is a sufferer. It is caused by overproduction of keratin that traps the hair follicle. This trapped hair follicle then generates inflammation which initially causes redness but in dark skins provokes the large melanocytes to overproduce the dark pigment melanin. Quite often, the bumps flatten out  but the dark skin remains causing serious distress and a poor aesthetic look.

The pigmentation caused is frequently deep dermal which is because the hair follicle that is trapped by the keratin is deep in the dermis.

Treatment of this in dark skinned people is different to that in fair skins. In dark skins  it involves removing the keratin as a matter of urgency to avoid trapping the hair follicle which can then start growing inwards and set up pigment causing inflammation. This keratin removal can be done using Retinoids, Glycolic acid, lactic acid, salicylic acid, Mandelic acid and urea.

In addition, this,melanin (dark pigment)production must be actively discouraged using depigmenters such as Kojic acid, arbutin, dioic acid, vitamin C,phytic acid etc. Two products designed to address both these necessary actions are

1) Photoagex serum-This is a high strength keratolytic emulsion that contains 15%Vitamin C ,12% glycolic & salicylic acid with a high strength 0.6% of retinaldehyde (retinoid). This combination dissolves & removes the keratin to release the trapped hair follicles. This serum should be massaged into skin two hours before bedtime.

2) Lightenex hand &foot cream-This is a 10% Urea based intensely moisturizing cream with skin whiteners namely Arbutin, Dioic acid & Niacinamide along with salicylic acid that will assist in hydrating the skin along with discouraging pigmentation. This should be massaged into skin twice daily.

*Results may vary in every individual.*

Shashi Gossain
Skincare Expert