Background: Literature suggests that manual lymphatic drainage therapy (MLDT) can positively impact general skin complexion. MLDT was selected as treatment for dark skin discolorations caused by post inflammatory hyperpigmentation (PIH). Purpose: The purpose of this study is to observe MLDT in reducing PIH. Methods: MLDT was performed on two adult women for more than 2 ½ months. Skin was observed each session with photographs taken pre/post treatment. Patient 1 had PIH related to leg flea bites and familial predisposition; Patient 2 had PIH from cystic acne at inner thighs. Each received 60-65 minute MLDT sessions, performed full body and locally on hyperpigmented areas. Instruction in diaphragmatic breathing began day 1, with each educated about diet and water intake. The Dermatology Life Quality Index (DLQI) was provided pre/post treatment. Frequency of treatment was individualized, patient 1 coming twice monthly for 4 months and patient 2 was weekly for 2 ½ months. Outcomes: Patient 1 had noticeable improvement in skin discoloration at 2 ½ months, with near complete resolution at 4 months. Patient 2 had partial resolution of skin discoloration at 2 ½ months. Discussion: Observable improvement in skin discoloration was seen in both cases, but longer duration treatment and habitual use of class 1 compression socks may explain the more complete resolution of PIH in patient 1. The DLQI deemed unnecessary by one patient, demonstrated improvement in the other, particularly in areas of clothing choice and intimacy. Conclusion: These findings suggest that MLDT may be a feasible non-invasive alternative for reducing PIH.
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