<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">JCDSA</journal-id><journal-title-group><journal-title>Journal of Cosmetics, Dermatological Sciences and Applications</journal-title></journal-title-group><issn pub-type="epub">2161-4105</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/jcdsa.2020.93010</article-id><article-id pub-id-type="publisher-id">JCDSA-101430</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine&amp;Healthcare</subject></subj-group></article-categories><title-group><article-title>
 
 
  Comprehensive Sequential Successful Therapy Comprising Chemical Peeling, Iontophoresis and Topical Vitamin C for Postinflammatory Hyperpigmentation in Acne Vulgaris
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Ichiro</surname><given-names>Kurokawa</given-names></name><xref ref-type="aff" rid="aff1"><sub>1</sub></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Department of Dermatology, Meiwa Hospital, Nishinomiya, Japan</addr-line></aff><pub-date pub-type="epub"><day>10</day><month>07</month><year>2020</year></pub-date><volume>09</volume><issue>03</issue><fpage>99</fpage><lpage>103</lpage><history><date date-type="received"><day>18,</day>	<month>June</month>	<year>2020</year></date><date date-type="rev-recd"><day>10,</day>	<month>July</month>	<year>2020</year>	</date><date date-type="accepted"><day>13,</day>	<month>July</month>	<year>2020</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  A 20-year-old man presented with for 6-month history of facial acne. He had erythema and red papules on the face secondary to BPO-induced contact dermatitis. He was administered topical corticosteroid. Contact dermatitis improved with this treatment, and he had red papules, comedones, prominent postinflammatory hyperpigmentation (PIH), postinflammatory erythema (PIE), erosions and erythema associated with acne vulgaris. He was subsequently treated with oral minocycline 100 mg/d and topical adapalene and ozenoxacin lotion once daily for 3 months. The inflammatory lesions and comedo subsided; however, PIH, PIE, atrophic scar and erosion persisted. During 3 months, the patient underwent chemical peeling using 20% glycolic acid (GA) and subsequent vitamin C iontophoresis twice at 1-month intervals. He showed almost disappearance of red papules and comedones but persistent PIH, PIE and erosion after 3 months of treatment. He was thereafter prescribed topical glyceryl-octyl-ascorbic acid/ascorbyl 2-phosphate 6-palmitate/DL-a-tocopherol phosphate complex for local application twice daily for 3 months. After 7 months of treatment, PIH, PIE, erosion and atrophic scar faded significantly with only trace residual erosions, atrophic scar and PIH. Subsequently, he was prescribed local application of 2% isostearyl-L-ascorbic acid gel vitamin C gel twice daily for 3 months. After 15 months, PIH, PIE, erosion and atrophic scar disappeared completely with significant improvement. Comprehensive sequential therapy resulted in significant improvement. It is suggested that medical treatment using systemic and topical antimicrobials and topical adapalene reduces inflammatory lesions and comedones initially. Subsequent chemical peeling using GA and vitamin C iontophoresis could improve PIH. These synergistic effects might have contributed to the significant improvement observed in this case. Comprehensive sequential treatment using chemical peeling, vitamin C iontophoresis and topical vitamin C can be a useful treatment strategy for PIH in acne vulgaris.
 
</p></abstract><kwd-group><kwd>Therapy</kwd><kwd> Facial Acne</kwd><kwd> Postinflammatory Hyperpigmentation</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>Conflicts of Interest</title><p>The author declares no conflicts of interest regarding the publication of this paper.</p></sec><sec id="s2"><title>Cite this paper</title><p>Kurokawa, I. (2020) Comprehensive Sequential Successful Therapy Comprising Chemical Peeling, Iontophoresis and Topical Vitamin C for Postinflammatory Hyperpigmentation in Acne Vulgaris. Journal of Cosmetics, Dermatological Sciences and Applications, 10, 99-103. https://doi.org/10.4236/jcdsa.2020.103010</p></sec></body><back><ref-list><title>References</title><ref id="scirp.101430-ref1"><label>1</label><mixed-citation publication-type="other" xlink:type="simple">Hayashi, N., Akamatsu, H., Iwatsuki, K., et al. (2018) Japanese Dermatological Association Guidelines: Guidelines for the Treatment of Acne Vulgaris 2017. Journal of Dermatology, 45, 898-935. https://doi.org/10.1111/1346-8138.14355</mixed-citation></ref><ref id="scirp.101430-ref2"><label>2</label><mixed-citation publication-type="other" xlink:type="simple">Callendar, V.D. (2004) Acne in Ethnic Skin: Special Considerations for Therapy. Dermatologic Therapy, 17, 184-195. https://doi.org/10.1111/j.1396-0296.2004.04019.x</mixed-citation></ref><ref id="scirp.101430-ref3"><label>3</label><mixed-citation publication-type="other" xlink:type="simple">Kurokawa, I., Yoshioka, M. and Ito, S. (2019) Split-Face Comparative Clinical Trial Using Glyceryl-Octyl-Ascorbic Acid/Ascorbyl 2-Phosphate 6-Palmitate/DL-α-tocopherol Phosphate Complex Treatment for Postinflammatory Hyperpigmentation, Postinflammatory Erythema and Atrophic Scar in Acne Vulgaris. Journal of Dermatology, 46, e347-e348. https://doi.org/10.1111/1346-8138.14930</mixed-citation></ref><ref id="scirp.101430-ref4"><label>4</label><mixed-citation publication-type="other" xlink:type="simple">Goh, C.L., Abad-Casintahan, F., Chow, S.K., et al. (2014) Evaluating Acne-Related Post-Inflammatory Hyperpigmentation Is a Challenge Even amongst Experts. Journal of Dermatology, 41, 1106-1108. https://doi.org/10.1111/1346-8138.12667</mixed-citation></ref><ref id="scirp.101430-ref5"><label>5</label><mixed-citation publication-type="other" xlink:type="simple">Goodman, G.J. (2001) Post-Acne Scarring: A Short Review of Its Pathophysiology. Australasian Journal of Dermatology, 42, 84-90. https://doi.org/10.1046/j.1440-0960.2001.00487.x</mixed-citation></ref></ref-list></back></article>