Acne frequently causes post-inflammatory hyperpigmentation (PIH), especially in patients with skin of color (SOC), which raises more concern to patients than the acne itself. Topical retinoids are used for treating acne and pigmentation disorders like melasma or mottled hyperpigmentation due to photodamage; moreover, they also benefit from hyperpigmentation in patients with SOC. Thus, early treatment with topical retinoids is advised unless contraindicated. 

Irritation can be eased by using novel formulations or applying commonly recommended moisturizers. Hyperpigmentation can also be improved by blending retinoids with other topical agents and procedures like superficial chemical peels. 

Primary acne lesions tend to improve even before PIH resolves and counselling patients may further lessen their worries. 

It is thus recommended to educate clinicians and researchers more about the presentation and management of dermatologic conditions in patients with SOC.

Source- Callender VD, Baldwin H, Cook-Bolden FE, Alexis AF, Stein Gold L, Guenin E. Effects of Topical Retinoids on Acne and Post-inflammatory Hyperpigmentation in Patients with Skin of Color: A Clinical Review and Implications for Practice. Am J Clin Dermatol. 2021 Nov 9. doi: 10.1007/s40257-021-00643-2. Epub ahead of print. PMID: 34751927.