Perbandingan Efektivitas antara Penggunaan Krim Pencerah dengan Tindakan Laser untuk Mengatasi Hiperpigmentasi Pascainflamasi (PIH): Systematic Review

Pendahuluan: Hiperpigmentasi pascainflamasi (PIH) merupakan kondisi dermatologis berupa deposisi melanin berlebih pada epidermis atau dermis akibat respons inflamasi kulit. PIH paling sering dijumpai pada individu dengan fotototipe kulit Fitzpatrick III–VI dan berdampak signifikan terhadap kualitas hidup. Dua modalitas utama yang banyak digunakan dalam penanganan PIH adalah krim pencerah dan tindakan laser, namun perbandingan efektivitas keduanya belum banyak dikaji secara komprehensif. Tujuan: Membandingkan efektivitas penggunaan krim pencerah dengan tindakan laser dalam mengatasi PIH pasien, baik dari segi intensitas, keamanan, waktu, serta biaya perawatan. Metode: Penelitian ini menggunakan desain literature review sistematis dengan penelusuran literatur menggunakan PubMed, Science Direct, Google Scholar, Proquest yang diterbitkan pada rentang waktu 2015-2025 meliputi original article, case-series, review article, randomized controlled trials berbahasa inggris maupun Indonesia yang akan dipilah dan dipilih sesuai dengan kata kunci berbasis analisi PICO. Hasil: Krim pencerah, terutama formula kombinasi (hidrokuinon + retinoid + kortikosteroid topikal), menunjukkan tingkat perbaikan klinis 75–90% setelah 8–24 minggu dengan tingkat keamanan yang baik. Terapi laser, khususnya Q-switched Nd:YAG dan picosecond laser, memberikan respons lebih cepat dengan tingkat perbaikan 60–85% namun disertai risiko PIH pascalaser yang lebih tinggi (10–30%) terutama pada kulit berwarna. Terapi kombinasi keduanya menunjukkan efektivitas superior hingga 90% dibandingkan modalitas tunggal. Kesimpulan: Krim pencerah lebih aman sebagai terapi lini pertama PIH, sedangkan laser efektif untuk kasus refrakter namun memerlukan seleksi pasien yang ketat. Kombinasi keduanya memberikan hasil optimal. Pemilihan terapi harus diindividualisasi berdasarkan fotototipe kulit, derajat keparahan, dan aksesibilitas pasien.
Kata kunci: Hyperpigmentasi Pascainflamasi (PIH), Krim Pencerah, Tindakan Laser, Tinjauan Literatur Sistematis.
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Introduction: Post-inflammatory hyperpigmentation (PIH) is a dermatological condition characterized by excessive melanin deposition in the epidermis or dermis as a consequence of cutaneous inflammatory responses. PIH is predominantly observed in individuals with Fitzpatrick skin phototypes III–VI and represents a significant aesthetic concern with considerable impact on quality of life. Two primary modalities widely employed in PIH management are lightening creams (depigmenting agents) and laser treatments; however, a comprehensive comparison of their effectiveness remains limited. Objective: To compare the effectiveness of lightening cream use and laser treatment in managing patients' PIH, in terms of intensity, safety, treatment duration, and treatment cost. Methods: This study employed a systematic literature review design, with literature searches using PubMed, ScienceDirect, Google Scholar, and ProQuest, covering publications from 2015 to 2025, including original articles, case series, review articles, and randomized controlled trials in both English and Indonesian, which were screened and selected according to PICO-based analysis keywords. Results: Lightening creams, particularly triple-combination formulas (hydroquinone + retinoid + topical corticosteroid), demonstrated clinical improvement rates of 75–90% after 12–24 weeks with a favorable safety profile. Laser therapies, especially Q-switched Nd:YAG and picosecond lasers, produced faster responses with improvement rates of 60–85%, but carried higher risks of post-laser PIH (10–30%), particularly in darker skin tones. Combined therapy demonstrated superior effectiveness of up to 90% compared to either modality alone. Conclusion: Lightening creams are safer and more suitable as first-line therapy for PIH, while laser treatment is effective for refractory cases but requires careful patient selection. Combined therapy yields optimal outcomes. Treatment selection should be individualized based on skin phototype, severity, and patient accessibility.
Keywords: Post-inflammatory Hyperpigmentation (PIH), Brightening Cream, Laser Therapy, Systematic Literature Review.