Objectives: This presentation discusses the approach to the management of common acquired facial pigmentary disorders in skin of colour,

Introduction: There are many causes of acquired facial pigmentation disorders. They tend to cost cosmetic disfigurement and affects quality of life for some. Some facial pigmentary disorders are due to excessive epidermal melanin accumulation others to dermal deposits and others both.

Materials / method: Recognition of type pigmentary disorders and the location of pigmentation are important as treatment regimens and prognosis of different pigmentary disorders varies. Different facial pigmentary disorders are treatable, others modifiable and others do not respond to treatment at all.

Results: In Asians, there are 4 major causes of acquired facial pigmentary disorders viz. lentigenes/ephilides, dermal melanocytosis (Hori’s naevus), melasma and post-inflammatory hyperpigmentation. A patient can have a combination of 2 or more pigmentary disorders. Lentigenes are readily removed by pigment lasers with short wavelengths or IPL after 1-2 treatments while Hori naevi and naevus of Ota require multiple longer wavelength Q-switch or picosecond lasers to treat. PIH and melasma are generally not very responsive to laser treatment as there is a tendency for PIH to develop.

Conclusion: The recent introduction of the picosecond lasers may improve the treatment outcome of some pigmentary skin disorders e.g. tattoos. Their efficaciousness is not impressive and awaits better treatment protocol to be developed.

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