ABSTRACT
The melanogenesis pathway, while genetically predetermined, is complex and can be affected and upregulated by varying endogenous and exogenous factors, including age, hormones, systemic or local inflammation, and sun exposure. Because hyperpigmentation may have significant psychosocial effects on patients, it is a frequently presented complaint in medical and cosmetic dermatology offices. While many physicians consider hyperpigmentation to be a purely aesthetic complication, there are many dermatologic and systemic conditions that are presented as facial or body dyschromia and it is prudent for the physician to complete a thorough evaluation of cause prior to prescribing treatment agents. Some agents in the market such as the antioxidants, botanical extracts, and synthetic medications have provided early promising results as monotherapies or adjunctive treatments to existing hyperpigmentation regimens. The tolerability of HQ and the long-term safety concerns remain a few of the disadvantages of this medication.
