skin barrier function testing in the Management of facial hyperpigmentation among adult dermatology patients

Feng Zhou; Y. Zhou; F. Wu

doi:10.5281/zenodo.22814457

Authors

Feng Zhou Division of Dermatology, Mackenzie Center for Dermatology Author https://orcid.org/0958-2114-3889-3709
Y. Zhou Department of Cosmetic and Aesthetic Surgery, Ob Center for Cosmetic and Aesthetic Surgery Author https://orcid.org/1894-0135-0052-0094
F. Wu Department of Dermatology, Columbia Academy of Cosmetic and Aesthetic Surgery Author https://orcid.org/5850-6376-4228-3445

DOI:

https://doi.org/10.5281/zenodo.22814457

Keywords:

skin barrier function, facial hyperpigmentation, melasma, transepidermal water loss, stratum corneum

Abstract

Graphical abstract

Background: The stratum corneum permeability barrier governs transepidermal water loss, surface pH, and resistance to irritant penetration, and its integrity is increasingly recognized as relevant to facial hyperpigmentation rather than an incidental bystander finding.

Objective: This review synthesizes evidence on noninvasive skin barrier function testing in adult patients with facial hyperpigmentation, principally melasma, and how barrier assessment can inform treatment selection.

Methods: We synthesized comparative biophysical studies, methodological guidelines, and treatment trials addressing transepidermal water loss, hydration, surface pH, and their relationship to pigmentary disease activity and tolerability.

Findings: Lesional melasma skin consistently shows elevated transepidermal water loss and reduced hydration relative to unaffected skin in the same patients, changes that track with disease activity; depigmenting agents vary in barrier impact, and barrier-supportive vehicles reduce irritant-driven treatment interruption.

Conclusions: Objective barrier function testing offers a practical basis for individualizing treatment intensity and sequencing in facial hyperpigmentation, and its routine incorporation into clinical evaluation is supported by a growing evidence base.

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