How to Tell Between Dermal or Epidermal Hyperpigmentation?

Question

How do I know if I have dermal or epidermal hyperpigmentation. I think I have a dermal hyperpigmentation because I have been using a regiment of Hyydroquinone 4% and Tretinoin .05% with minimal improvement.

Jeffrey Zwiren, MD · Answer

The treatment would be the same.  If you are developing a post inflammatory hyperpigmentation.  Treatment for this type of problem includes the use of hydroquinone 4 to 8 %, Kojic acid, Retin-A, Topical steroid creams.  You can expect it to take up to 10 weeks for the pigmentation to clear.  Also available from a compounding pharmacy is Klingman's formula which is a mixture of all of the above chemicals.

John P. Di Saia, MD · Answer

Hello,
Epidermal hyperpigmentation tends to be short lived and/or easily corrected with the medications you are using. The fact that the improvement is minimal hints that the problem may be deeper. Hopefully you are getting professional help with this to help focus your erfforts.

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