Biology

Phototype

Surgery

Niacinamide

Dermatology

Biochemistry

Placebo

Alternative medicine

Enzyme

Nicotinamide

Medicine

Chemistry

Double blind

Hyperpigmentation

Pathology

Clinical Cosmetic and Investigational Dermatology

Topical niacinamide 4% and desonide 0.05% for treatment of axillary hyperpigmentation: a randomized, double-blind, placebo-controlled study Juan Pablo Castanedo-Cazares,1 Gabryela L&aacute;rraga-Pi&ntilde;ones,1 Adriana Ehnis-P&eacute;rez,1 Cornelia Fuentes-Ahumada,1 Cuauhtemoc Oros-Ovalle,2 Bruce R Smoller,3 Bertha Torres-&Aacute;lvarez11Department of Dermatology, 2Department of Pathology, Hospital Central Dr Ignacio Morones Prieto, Universidad Aut&oacute;noma de San Luis Potos&iacute;, M&eacute;xico; 3Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AK, USABackground: Axillary hyperpigmentation is a frequent cause of cosmetic consultations in dark-skinned women from tropical areas, including Latin America. Currently, there is no widely accepted treatment for the disorder, but it is usually treated with bleaching agents because it is considered a variant of inflammatory hyperpigmentation. The purpose of this study was to assess the efficacy of niacinamide 4% and desonide 0.05% emulsions compared with placebo in the treatment of axillary hyperpigmentation.Methods: Twenty-four women aged 19&ndash;27 years with hyperpigmented axillae (phototype III&ndash;V) were randomly assigned to receive the study treatments in the axillary region. Improvement was assessed at baseline, then clinically and by colorimetry 9 weeks later. Quantitative evaluation including melanin, inflammatory infiltrates, NKI/Beteb, CD1a, CD68, and collagen type IV content was performed by histochemistry and immunohistochemistry, assisted by computerized morphometric analysis.Results: Both niacinamide and desonide induced significant colorimetric improvement compared with placebo; however, desonide showed a better depigmenting effect than niacinamide. A good to excellent response was achieved in 24% of cases for niacinamide, 30% for desonide, and 6% for placebo. We observed a marked disruption of the basal membrane in axillary hyperpigmentation and an inflammatory infiltrate that improved after treatment. Decreased pigmentation in the desonide-treated axillae was associated with recovery of disruption at the basal membrane.Conclusion: Niacinamide and desonide showed depigmenting properties in women with axillary hyperpigmentation. These findings may be explained by their antimelanogenic and anti-inflammatory properties, respectively.Keywords: post-inflammatory hyperpigmentation, niacinamide, desonide

Topical niacinamide 4% and desonide 0.05% for treatment of axillary hyperpigmentation: a randomized, double-blind, placebo-controlled study