Idiopathic Guttate Hypomelanosis Treatment & Management

Updated: Aug 14, 2017
  • Author: Christopher R Gorman, MD; Chief Editor: William D James, MD  more...
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Treatment

Medical Care

Medical therapy for idiopathic guttate hypomelanosis includes corticosteroids, either topical or intralesional, and retinoids, typically topical tretinoin. [11] One report describes successful treatment with pimecrolimus 1% [6] ; however, caution is warranted because the author has anecdotal experience possibly suggesting that topical calcineurin inhibitors may be linked to the development of idiopathic guttate hypomelanosis in immunosuppressed patients. Another described successful treatment with topical tacrolimus, but results were not statistically significant after clinical assessments. [12]

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Surgical Care

Surgical techniques, from cryosurgery to dermabrasion, have been tried for idiopathic guttate hypomelanosis, with some success. [1] Theoretically, cryotherapy would remove the damaged melanocytes, which would encourage normal melanocytes to replace them. A randomized, controlled, evaluator-blinded study of 101 lesions treated with a single 5-second tip cryotherapy treatment demonstrated 82.3% of the lesions improved by 75% at 4 months. [13] Fractional carbon dioxide laser and nonablative fractional photothermolysis treatment have been reported as safe and effective. [14, 15, 16] Excimer laser also may be safe and effective using the vitiligo protocol. [17] The use of a spot 88% phenol peel is another option; however, persistent scabbing and hyperpigmentation are potential adverse effects. [18]

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Consultations

In doubtful cases, a consultation with a dermatologist should precede any laboratory or biopsy studies.

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Prevention

Idiopathic guttate hypomelanosis may be avoided, at least until late in life, by protection against sun damage.

Avoiding sun tanning is an important adjunct to prevention of idiopathic guttate hypomelanosis because tanning accentuates the process and intensifies the pigmentary contrast. Artificial tanning using dihydroxyacetone-containing topical agents is a good alternative.

One report suggests that patients in the study who used “body scrubbers” had an increased likelihood having idiopathic guttate hypomelanosis lesions. [19]

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Long-Term Monitoring

Sunscreens are advised because idiopathic guttate hypomelanosis is a marker of sun damage.

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