Treatment modalities for exogenous ochronosis: A narrative review of current and emerging therapeutic approaches. (Treatment of exogenous ochronosis)

Exogenous ochronosis is a chronic skin disorder characterized by dermal hyperpigmentation, often resulting from prolonged use of hydroquinone. This review analyzed 29 studies (2000-2025) assessing treatments for exogenous ochronosis. Laser and light-based therapies, particularly in combination regimens, showed the greatest efficacy, while microneedling and chemical peels provided moderate improvement. Topical agents alone offered limited benefit. Post-inflammatory hyperpigmentation was the most frequent adverse event. Emerging modalities, including intradermal vitamin C, exosome therapy, and platelet-rich fibrin lysate, demonstrated promising early results. Overall, multimodal and light-based therapies appear to be the most effective; however, further controlled studies are essential to confirm their safety and long-term outcomes.

Keywords: Ochronosis; Hyperpigmentation; Dermabrasion