Hyperpigmentation Disorders Management in India

INTRODUCTIONHyperpigmentation disorders impose a substantial clinical and psychosocial burden in individuals with darker skin phototypes, yet remain underrepresented in dermatological research. In India, where a large proportion of the population reports pigmentary concerns, conditions such as post-inflammatory hyperpigmentation (PIH), melasma, and periorbital hyperpigmentation significantly affect quality of life. Conventional therapies are often limited by irritation, relapse, safety concerns in skin of color, and poor long-term adherence, prompting interest in dermocosmetic alternatives with improved tolerability.

OBJECTIVETo establish expert consensus on the epidemiology, clinical challenges, and evolving management strategies for hyperpigmentation in India, with particular focus on dermocosmetics and non-tyrosinase depigmenting agents.

METHODSA modified Delphi consensus was conducted among senior dermatologists from multiple Indian states. Findings from a multinational epidemiological survey (34 countries; 48 000 participants, including 1000 from India) were integrated with a structured pre-consensus survey assessing clinical patterns and treatment practices. An in-person advisory board meeting (Jaipur, February 2025) facilitated iterative discussions on disease burden, therapeutic approaches, procedural interventions, and emerging depigmenting agents, including 2-mercaptonicotinoyl glycine (2-MNG).

RESULTSMelasma was the most frequently encountered pigmentary disorder in Indian practice (mean 32%), followed by acne induced PIH (21.5%) and non-acne PIH (13.1%). Key challenges included treatment resistance, recurrence, irritation, quality of life impairment, procedural downtime, and limited maintenance options. The panel identified 2-MNG as a promising depigmenting agent with a non-tyrosinase mechanism and favorable tolerability in darker skin phototypes.

LIMITATIONSFindings are based on expert consensus, existing literature, and limited survey data; larger long term clinical studies in Indian populations are warranted.

CONCLUSIONDermocosmetic innovations such as 2-MNG may address unmet needs in hyperpigmentation management in skin of color, highlighting the need for tailored, evidence-based strategies.

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