Vitiligo and Hyperpigmentation

HYPO- AND HYPERPIGMENTATION: A DUAL THERAPY STRATEGY

✅ Vitiligo is a loss of melanin pigment

✅ Hyperpigmentation is an excess of melanin pigment

Vitiligo and hyperpigmentation can occur in the same patient on different areas of the skin, and, as a rule, for different reasons. Most patients are concerned about the situation when hypo- and hyperpigmentation are simultaneously present on the face and neck.

Combined treatment of vitiligo and hyperpigmentation on the face requires a careful and individual approach, since these conditions are opposite in nature and treatment of one condition can aggravate the other.

Basic algorithm of actions

🔍 1. Consultation with a dermatologist and accurate diagnosis

It is important to clarify:

• Type of hyperpigmentation (melasma, post-inflammatory, lentigo, etc.)
• Causes of vitiligo (autoimmune diseases, stress, contact triggers)
• Location, stage, and activity of vitiligo (stable or progressive)

🧩 2. Selection of products and procedures taking into account the balance 

For vitiligo:

• Melagenin Plus (human placenta extract) until the spots are completely covered
• Opzelura (rupacitinib) for the face and neck (the duration of the course is calculated by the doctor)
• Phototherapy (NB-UVB) is effective, but can increase hyperpigmentation in other areas.
• Antioxidants and immune system support

For hyperpigmentation:

• Soft lightening agents: niacinamide, azelaic acid, arbutin, with caution - vitamin C
• Procedures: laser (only if there is no vitiligo nearby), microdermabrasion, IPL - only on the recommendation of a doctor

⚖️ 3. Treatment strategy for both conditions

✅ Treat vitiligo as a priority if it is active - Maintaining remission is more important than eliminating aesthetic defects of hyperpigmentation

✅ Stabilize vitiligo before active hyperpigmentation therapy - Wait for remission

✅ Local treatment with different agents - Use bleaching/retinoids only on hyperpigmented areas, Melagenin Plus only on vitiligo

✅ Avoid aggressive treatment of hyperpigmentation - especially acids and lasers - they can worsen vitiligo

🌞 4. Mandatory sun protection

• SPF 50+, broad spectrum
• Daily application, especially on exposed areas. Physical filters are preferable (Zinc Oxide and Titanium Dioxide) to reduce the risk of irritation.

🗓️ 5. Control and monitoring

✅ Photographic recording once every 1–3 months

✅ Measuring vitiligo activity (e.g. using VES score)

✅ Control of side effects