Acne frequently leads to post-inflammatory hyperpigmentation (PIH), especially in those with a skin of color (SOC). Topical retinoids are approved for managing acne and pigmentation disorders like melasma or mottled hyperpigmentation caused due to photodamage. Topical retinoids can also reduce hyperpigmentation in patients with SOC. Thus, treatment with topical retinoids should be initiated as early as possible unless contraindicated. 

Using novel formulations or applying generally recommended moisturizers may help lessen the irritation. Combining retinoids with other topical agents and procedures like superficial chemical peels can further improve hyperpigmentation. Generally, primary acne lesions resolve weeks before PIH, thus assisting patients to manage their expectations may reduce frustration. 

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

Source: Callender VD, Baldwin H, Cook-Bolden FE, et al. 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. 2022;23(1):69-81.