Facial Hyperpigmentation Caused by Pigmented Demodicosis

This document presents a case of facial hyperpigmentation in a 16-year-old male, attributed to pigmented demodicosis, a condition caused by the overgrowth of Demodex mites. Despite previous treatments with topical retinoid and hydroquinone, the patient showed no improvement until the introduction of oral isotretinoin and ivermectin 1% cream, which led to significant improvement after 3 months. Histopathological examination revealed Demodex mites in dilated hair follicles, supporting the diagnosis. The study emphasizes the importance of considering demodicosis as a differential diagnosis for chronic or treatment-resistant facial hyperpigmentation, especially in patients with skin of color, as early recognition and treatment can lead to significant clinical improvement.