How to Tell Between Dermal or Epidermal Hyperpigmentation?

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.

Doctor Answers 2

Hyperpigmentation treatment

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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.

Persistence hints towards dermal hyperpigmentation

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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.

John P. Di Saia, MD
Orange Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.