On the first day of the AAD annual meeting, Seemal Desai, MD, FAAD, highlighted the current treatment options, and what’s down the pipeline for acne dyspigmentation. His focus was primarily on new non-hydroquinone-based topical lightning agents, and chemical peels, particularly combination chemical peels.

"All of us in this room have had patients who have acne, but when they come to see us, they're not coming because they're worried about the bumps, the papules, or the pustular cysts. They're worried about the marks", Dr Desai stated echoing his sneak peek preview prior to his session. 

Dr Desai went on to list the current treatment options physicians could utilize such as:

• azelaic acid
• retinoids
• topical cysteamine
• topical and oral tranexamic acid
• chemical peels such as salicylic acid, mandelic, and lactic acid peels

He noted that physicians tend to frequently rely on hydroquinone-based therapies as skin lightning agents; however, this could pose a challenge for post-inflammatory hyperpigmentation.

“For example, you can't have your patient smear the lightning cream all over, otherwise they're also going to bleach the normal skin tone,” he added.

He shared that, in his practice, he typically uses a combination of salicylic and mandelic acid as a sequential chemical peel during one session by layering each of these agents to achieve an optimal endpoint. He added that the synergy between the beta hydroxy acid of salicylic and the alpha hydroxy acid of mandelic was so effective he tends to do these sessions every 4 weeks for 3—5 sessions.

Reference
Desai S. Update on treatment of dyspigmentation in acne and rosacea. Presented at: AAD Annual Meeting; March 25-28, 2022; Boston, MA.