Treatment of hyperpigmentation after burn: A literature review.

Elise Lupon, Jérôme Laloze, Benoit Chaput, Paul Girard, Curtis L Cetrulo, Laurent A Lantieri, Jean Louis Grolleau, Olivier Camuzard, Alexandre G Lellouch

Journal: Burns : journal of the International Society for Burn Injuries 2022;48(5):1055-1068

PMID: 35537921

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Abstract

OBJECTIFY

Skin pigmentation disorders are one of the most frequent sequelae after burn injury. While these conditions often improve over time, some are permanent and cause severe psychological disorders (especially on the face). Given the frequency of these disorders and their benign nature, the scientific community has great difficulty postponing these patient follow-ups. Publications on their management are rare, and there is no consensus on the gold standard treatment for skin dyschromia. Herein, we performed a literature review including the various treatments currently proposed to manage these hyperpigmentations.

METHODS

All reported articles up to February 2021 were reviewed on Pubmed. Studies on the treatment of hyperpigmented scars were included if they were secondary to burn injuries. Excluded articles evaluated transient treatments, such as makeup, and articles on inflammatory hyperpigmentation without etiological details or not secondary to burns.

RESULTS

201 articles were identified, and 13 studies were included. Topical creams used in inflammatory hyperpigmented lesions such as hydroquinone and first-line retinoids are controversial due to their inconstant efficacy. Various types of laser and pulsed light treatments have shown their effectiveness but can also aggravate pigmentation.

CONCLUSION

Dyschromia after burn remains a therapeutic challenge. Hyperpigmentations after burn should be treated on a case-by-case basis, using data from the literature, clinical experience and measuring the risk/benefit ratio.

Address: Department of Plastic Surgery, University Toulouse III Paul Sabatier, Toulouse, France; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Plastic and Reconstructive Surgery, Pasteur 2 Hospital, University Côte d'Azur, Sophia Antipolis, Nice, France. Electronic address: [email protected].; Department of Plastic surgery, Medical School, University of Limoges, Limoges, France.; Department of Plastic Surgery, University Toulouse III Paul Sabatier, Toulouse, France. Electronic address: [email protected].; Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France.; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Plastic Surgery, Massachusetts General Hospital, Boston, MA, USA.; Department of Plastic Surgery, European Georges Pompidou Hospital, University of Paris, Paris, France. Electronic address: [email protected].; Department of Plastic Surgery, University Toulouse III Paul Sabatier, Toulouse, France. Electronic address: [email protected].; Department of Plastic and Reconstructive Surgery, Pasteur 2 Hospital, University Côte d'Azur, Sophia Antipolis, Nice, France. Electronic address: [email protected].; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Plastic Surgery, European Georges Pompidou Hospital, University of Paris, Paris, France; Lecturer at Massachusetts General Hospital and Shriners Hospitals for Children. Department of Plastic Surgery, Massachusetts General Hospital/ Harvard Medical School, Boston, MA, USA. Electronic address: [email protected].

DOI: 10.1016/j.burns.2022.04.017

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MeSH Terms: Burns, Humans, Hyperpigmentation, Treatment Outcome