Axillary Hyperpigmentation Treatment: A Systematic Review of the Literature

August 2025 in “ Journal of Cosmetic Dermatology ”

Seyed Mohammad Vahabi, Hamid Sajjadi, Yasamin Kalantari, Elnaz Pourgholi, Sama Heidari, Ifa Etesami

axillary hyperpigmentation topical treatments light-based therapies laser-based therapies desonide Cyperus rotundus oil Q-switched Nd:YAG laser intense pulsed light alpha-hydroxy acid IPL QS Nd-YAG laser

Studysummary In this systematic review, researchers examined various treatments for axillary hyperpigmentation, finding that Q-switched Nd:YAG laser and intense pulsed light showed significant improvement with minimal adverse effects; desonide and Cyperus rotundus oil were also notably effective among topical treatments. Our plain-language summary of this paper — not a Tressless recommendation.

This systematic review assessed the efficacy and safety of treatments for axillary hyperpigmentation (AH) across 10 studies, focusing on topical treatments and light/laser-based therapies. Topical agents like desonide and Cyperus rotundus oil were effective with minimal side effects, while the Q-switched Nd:YAG laser and intense pulsed light (IPL) showed significant improvement in pigmentation, though the laser was more painful. IPL was found superior to alpha-hydroxy acid for skin lightening. The review concluded that the QS Nd-YAG laser is the most frequently used laser for AH treatment without severe adverse effects, and various topical treatments are effective. However, no gold standard exists, and further research is needed to establish standardized treatment protocols.

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Research cited in this study

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research Topical Cyperus Rotundus Essential Oil for Treatment of Axillary Hyperpigmentation: A Randomized, Double-Blind, Active- and Placebo-Controlled Study

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In this study, Cyperus rotundus essential oil was found to have significantly better depigmenting effects than hydroquinone for treating axillary hyperpigmentation, with additional benefits in reducing inflammation and hair growth, making it a cost-effective and safe treatment option.

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research Topical Niacinamide 4% and Desonide 0.05% for Treatment of Axillary Hyperpigmentation: A Randomized, Double-Blind, Placebo-Controlled Study

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In this study, niacinamide 4% and desonide 0.05% emulsions significantly improved axillary hyperpigmentation in women, with desonide demonstrating a superior depigmenting effect compared to niacinamide and placebo.