Treatment of acne-induced post-inflammatory hyperpigmentation with topical bakuchiol cream.
Nahhas AF, Braunberger TL, Kohli I, Mohammad TF, Nicholson C, Nartker NT, Modi K, Matsui M, Lim HW, Hamzavi I. Treatment of acne-induced post-inflammatory hyperpigmentation with topical bakuchiol cream.. J Invest Deramtol 2018; 138(5):S85.
J Invest Deramtol
Post-inflammatory hyperpigmentation (PIH) is an acquired hypermelanosis that occurs following cutaneous inflammation or injury and often after acne. Therapies targeting oxidative stress and inflammation may hasten PIH resolution. We evaluate treatment efficacy of topical bakuchiol, a botanical with antioxidant and anti-inflammatory properties, on acne-induced PIH. A prospective, single-blinded, non-randomized study was conducted in 20 subjects (phototypes IV-VI) with acne-induced PIH. On day 0, three facial acne papules/pustules were identified. On day 28, after PIH formation, subjects applied topical bakuchiol cream (product) and vehicle cream, twice daily on two separate lesions for 28 days; third lesion was control. Clinical photography, Investigator Global Assessment (IGA) scores for hyperpigmentation, Post-acne hyperpigmentation index (PAHPI), and colorimetry performed on days 0, 28, 35, 42, and 56. Degree of improvement was defined as change in normalized colorimetry L* (L*) parameter between days 28 and 56. Paired t-test was performed and p values less than 0.05 were considered statistically significant. Colorimetry delta L* for 20 subjects showed product sites had 2.5-fold (p=0.13) and vehicle sites had 1.2-fold (p=0.87) improvement in hyperpigmentation compared to control sites. A statistically significant correlation, 0.95, existed between delta L* and time for product site only (p=0.04). IGA scores and PAHPI exhibited similar trends, though not reaching statistical significance. Topical bakuchiol offered some protection, but not statistically significant. Longer follow up could lead to clinically significant response.