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The Hyperpigmentation Clinic of Harley Street

Hyperpigmentation post Eczema


Eczema is a form of inflammation. Symptoms include dry, red, itchy skin.
Flare ups happen intermittently and most cases of eczema develop early in childhood but can happen at any stage of life.

The current treatment advice is to:

1. Avoid irritants
2. Moisturise
3. Apply topical steroids


Typical cases

At The Hyperpigmentation Clinic, we typically see clients with hyperpigmentation on the arms and legs after eczema.
The pigmentation looks widespread with no clear margins.
Clients tend to worry more about lower arms and lower legs as this is generally more exposed and therefore more visible.

Pathology
The pathology is called Melanosis.

During a flare up, inflammatory mediators are released e.g. prostanoids and cytokines. These chemicals excite the Melanocytes (cells that produce the pigment melanin). This therefore increases the production of pigmentation.

Pigmentation after Eczema is much more common in those with darker skin as the melanocytes are easily triggered. In Caucasians, erythema is more likely to be seen.

Treatment of Hyperpigmentation after Eczema

1. Avoid the sun. Wear long sleeve tops and trousers, to prevent the sun exacerbating hyperpigmentation.

2. The Hyperpigmentation Clinic offers a treatment that is highly effective in alleviating post-eczema hyperpigmentation.

Our protocol for treating hyperpigmentation post eczema in darker skin is as follows:
(a). Thin the corneum (top layer of skin) with a preparation cream to allow better penetration of the mask.
(b). Load the skin with vitamin C to strengthen the skin and allow rapid skin growth post peel.
(c).  The mandelic peel is applied. This allows tyrosinase inhibitors to penetrate the skin and calm down the overactive melanocytes
(d). Post treatment creams are used to continue to calm down the melanocytes
(e). Skin protection provided to allow new, young, healthy skin cells to grow.

 
Treatments to avoid in darker skin are:
1. Laser
2. Glycolic peels
3. TCA peels

The reason being that these treatments can lead to burns, which manifests as Post Inflammatory Hyperpigmentation.