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SourcesThe studies behind what we say about post acne
Where this comes from.
9 claims · 15 studies.
C1-1
L-ascorbic acid is the most-studied vitamin C form (direct tyrosinase inhibition); requires pH 2.5-3.5 to penetrate, which can itself trigger PIH on reactive Fitzpatrick IV-VI skin.
Verified
C2-6
Tranexamic acid is an antifibrinolytic lysine analogue that binds the lysine-binding sites of plasminogen and so reduces plasmin generation. In guinea pigs, topical tranexamic acid applied after UV exposure reduced UV-induced pigmentation and arachidonic-acid-induced pigmentation; the authors propose that UV raises epidermal plasmin activity, plasmin promotes arachidonic acid release and prostaglandin production, and these arachidonic-acid metabolites stimulate melanocyte tyrosinase (arachidonic-acid metabolites do stimulate tyrosinase in cultured human melanocytes). This chain rests on animal and cell-culture data and is not established in humans.
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Maeda K, Naganuma M. J Photochem Photobiol B 1998;47(2-3):136-41. PMID 10093913
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Tomita Y, Maeda K, Tagami H. Pigment Cell Res 1992;5(5 Pt 2):357-61. PMID 1292020
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Steinmetzer T, Pilgram O, Wenzel BM, Wiedemeyer SJA. J Med Chem 2019;63(4):1445-1472. PMID 31658420
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Silva MMCG, Thelwell C, Williams SC, Longstaff C. J Thromb Haemost 2012;10(11):2354-60. PMID 22974122
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Hushcha Y, Giuliani AL, Fernanda M, Bononi I, Mazziotta C, Rotondo JC, De Mattei M (author names as listed in PubMed). Cell Biol Int 2025;50(1):e70097. PMID 41147757
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Perper M, Eber AE, Fayne R, Verne SH, Magno RJ, Cervantes J, ALharbi M, ALOmair I, Alfuraih A, Nouri K. Am J Clin Dermatol 2017 Jun;18(3):373-381. PMID 28283893
C2-7
In cultured melanocytes and keratinocyte-melanocyte models, tranexamic acid reduces melanin content, tyrosinase activity and tyrosinase protein by acting on signalling upstream of the enzyme, rather than being characterised as a direct tyrosinase-enzyme inhibitor. It does so both through a keratinocyte paracrine route (tranexamic acid raised keratinocyte TGF-beta1, which suppressed melanogenesis in melanocytes) and directly on melanocytes (ERK-MITF degradation; cAMP-PKA-CREB-MITF; VEGF-receptor signalling). The evidence is in vitro; in a 30-patient refractory-melasma series, oral tranexamic acid was followed by lower epidermal pigmentation and Melan-A staining.
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Kim MS, Bang SH, Kim JH, Shin HJ, Choi JH, Chang SE. Ann Dermatol 2015;27(3):250-6. PMID 26082580
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Xing X, Xu Z, Chen L, Jin S, Zhang C, Xiang L. Exp Dermatol 2021 Dec 17;31(4):633-640. PMID 34862827
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Bae YJ, Lee EJ, Kim JY, Park S, Hwang S, Kwon IJ, Alqahtani JM, Oh SH. Exp Dermatol 2025;34(12):e70194. PMID 41392597
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Zhu JW, Ni YJ, Tong XY, Guo X, Wu XP, Lu ZF. Int J Med Sci 2020;17(7):903-911. PMID 32308543
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Nagaraju D, Bhattacharjee R, Vinay K, Saikia UN, Parsad D, Kumaran MS. Dermatol Ther 2018;31(5):e12704. PMID 30253023
C10-1
HOCl is produced endogenously by neutrophils as part of the innate immune response.
Verified
C10-3
Sodium hypochlorite solution pH is 11-12; disrupts skin acid mantle on contact.
Verified
C13-3
A brief benzoyl peroxide contact suppresses S. aureus without the full-spectrum damage of longer-contact antibacterial washes.
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A New, Once-daily, Optimized, Fixed Combination of Clindamycin Phosphate 1.2% and Low-concentration Benzoyl Peroxide 2.5% Gel for the Treatment of Moderate-to-Severe Acne.
C24-1
Acne is a common cause of PIH, particularly in skin of color; resulting marks are often more distressing to patients than the acne itself.
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Effects of Topical Retinoids on Acne and Post-inflammatory Hyperpigmentation in Patients with Skin of Color: A Clinical Review and Implications for Practice.
C24-2
In skin of color, acne treatment must balance efficacy against irritation, because irritation itself triggers PIH; treat early, titrate gently.
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Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color.
C24-3
Topical retinoids and azelaic acid treat acne and reduce post-acne hyperpigmentation in skin of color.
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Effects of Topical Retinoids on Acne and Post-inflammatory Hyperpigmentation in Patients with Skin of Color: A Clinical Review and Implications for Practice.
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