From the Research
For hyperpigmentation on the forehead, I recommend a combination approach including topical treatments, sun protection, and possibly in-office procedures, with the most effective treatment being a combination of oral tranexamic acid and topical hydroquinone, as shown in a recent study 1.
Treatment Approach
To address hyperpigmentation on the forehead, consider the following steps:
- Start with daily application of topical retinoids like tretinoin 0.025-0.05% at night, which promotes cell turnover and gradually fades dark spots.
- In the morning, apply a vitamin C serum (10-20% L-ascorbic acid) followed by a broad-spectrum sunscreen with SPF 30-50, reapplied every 2 hours when outdoors.
- Add a tyrosinase inhibitor such as hydroquinone 2-4% (limited to 8-12 week cycles), azelaic acid 15-20%, or kojic acid to directly reduce melanin production.
In-Office Procedures
For stubborn hyperpigmentation, consider professional treatments like:
- Chemical peels (glycolic or lactic acid)
- Microdermabrasion
- Laser therapy Results typically take 8-12 weeks to become noticeable, as hyperpigmentation results from excess melanin production, and these treatments target different aspects of the pigmentation pathway while preventing further darkening from UV exposure, which is essential for successful treatment, as noted in a study on melasma treatment 2.
Recent Evidence
A 2022 study 3 highlights the importance of a systematic approach to diagnosing and managing hyperpigmentary disorders, considering factors such as disease pathogenesis and the use of topical skin-lightening agents, while a 2020 study 1 demonstrates the efficacy of combining oral tranexamic acid with topical hydroquinone for treating melasma.