Hyperpigmentation is a difficult condition to treat successfully – that’s in large part due to the complex process the skin undergoes and the interconnected reactions that occur.
Effective topical treatments are designed to interrupt melanin production at multiple points, however, the most effective approach for treating hyperpigmentation appears to be a multi-layered approach that uses a variety of products. This approach uses different ingredients to alternately suppress and stimulate different areas of the process, leading to accelerated results, compared to results typically found by using just one topical hyperpigmentation treatment. We are not suggesting you can or should use all of the products outlined below at once, but a combination of two or more, can being about a better result than a single treatment.
Hydroquinone (HQ) – the most prescribed skin-lightening agent use to treat hyperpigmentation. HQ suppresses and inhibits the activity that causes dark spots/patches. HQ also decreases and degrades the formation of melanin. Over-the-counter forms of Hydroquinone can contain up to 2% concentration of the ingredient. Stronger forms of the product are available with a prescription, but can lead to skin irritation and inflammation. Patch testing is recommended before using this product. Read more about Skin Lightening and hydroquinone here.
Kojic Acid – Kojic acid effectively interrupts the process that causes hyperpigmentation. However, Kojic acid is considered an unstable ingredient in cosmetic formulations – it can lose it efficacy when exposed to air and sunlight. Many cosmetics companies use kojic dipalmitate as an alternative because it is far more stable in formulations. However, there is no research showing that kojic dipalmitate is as effective as kojic acid, though it is a good antioxidant. Kojic acid can be irritating to the skin, so highly sensitive patients should conduct a patch test before using.
Lactic Acid – this is a water-soluble alpha-hydroxy-acid (AHA) that increases exfoliation of the skin. The dark patches are lifted and removed and eventually fade. Lactic acid also suppresses the formation of tyrosinace (an enzyme responsible for the formation of melanin).
L-ascorbic Acid – this can prevent the formation of melanin. Its antioxidant, anti-inflammatory and UV-protective capabilities are also important in the suppression of melanin formation.
Retinoids – All forms of retinoid (retinoic acid, retinol and retinaldehyde) inhibit tyrosinace (the enzyme responsible for the formation of melanin) and enhances cell turnover. Retinol is converted to retinoic acid in the skin which can be problematic for people with sensitive skin since this irritating process can actually stimulate the formation of melanin.
Azelaic Acid – this also inhibits tyrosinace activity and suppresses and reduced the formation of melanin.
Arbutin– this is a natural derivative of Hydroquonine that allows the controlled release of HQ into the skin. Arbutin also suppresses the activity of tyrosinase, prevents the formation of melanin and acts as an antioxidant. (Since Arbutin is a derivative of Hydroquonine, it does not come without risks – read more about Hydroquonine before using either product).
Chemical Peels – Part of the successful treatment of hyperpigmentation is the increase of cellular turnover and the removal of darker cells to keep the appearance of pigmented areas to a minimum. This is achieved with a gentle, superficial peel every 3-4 weeks. It’s important to avoid strong chemical peels with a high percentage of acid and mechanical methods like scrubs or harsh loofahs – all these can actually stimulate melanin production.
THE IMPORTANCE OF SUNSCREEN
The daily use of a broad spectrum sunscreen with SPF30 or more is essential for people with hyperpigmentation. The inflammation (reaction) caused by UV exposure is a direct cause of melanin production.