Hyperpigmentation is a problem that affects millions of people all around the world and can cause significant distress and self-esteem issues among sufferers. Hyperpigmentation is caused by the over-production of melanin (pigment) in the deeper layers of the skin, and usually presents itself as dark spots on the face, hands, neck and exposed limbs. Hyperpigmentation can be initiated in otherwise healthy skin by a number of contributing factors, these include sun exposure, hormone fluctuations and skin injury.
Fortunately, there are a number of proven ingredients formulated into over-the-counter creams that can help treat hyperpigmentation. We’ll take a look at five of the best:
- Cysteamine is a natural antioxidant found in the human body. Produced through the metabolization of the essential amino acid L-cysteine, when applied to the skin it acts to inhibit melanin production resulting in depigmentation and a clearer complexion.
The skin depigmenting properties of cysteamine were first discovered back in 1966 when researchers injected cysteamine into the skin of black goldfish and found that the goldfish turned white.
Subsequent studies confirmed the depigmenting effect of cysteamine was more significant than hydroquinone. It was rare to find a more potent depigmenting agent than hydroquinone in vivo and researchers began to formulate cysteamine into a topical cream.
In 2015, the British Journal of Dermatology published study results confirming the efficacy of 5% cysteamine for the treatment of melasma.
Besides its depigmentating properties, cysteamine is also known for being an antimutagenic agent and anticarcinogenic.
- Hydroquinone was, for many years, the ingredient of choice to treat hyperpigmentation disorders. Much like cysteamine, it works by suppressing melanin production. It does this in two ways, first by inhibiting tyrosinase, an enzyme needed for melanin production; and secondly, by breaking down the melanin granules in melanin producing cells. While this means it can’t clear the melanin already present in the epidermis (outer-layer of skin), it does prevent further pigment production. Unfortunately, due to recent fears over its link to a cancer inducing effect in animal studies and ochronosis in people, restrictions have been applied to the use of hydroquinone in almost all worldwide markets. It is still available over the counter in the USA in 2% formulations, while stronger doses can only be secured through prescription.
- Kojic acid is produced by several types of fungi and is a by-product of the fermentation process for the Japanese rice wine, sake. It is often favoured by dermatologists in combination with glycolic acid. When used alone, results are comparable to hydroquinone 2% but it has been found to more irritable on the skin. Additionally, kojic acid is particularly unstable in cosmetic products, oxidizing when in contact with air and reacting to other chemicals if exposed to sunlight. To get around these barriers, it is often substituted for kojic acid dipalmitate, a more stable derivative but few studies have been completed comparing its efficacy with either kojic acid or other ingredients.
- Glycolic acid is an alpha-hydroxy acid (AHA), a chemical compound group well known in the cosmetic world for their ability to reduce wrinkles and defined lines. Gylcolic acid, being the AHA with the smallest molecular size, is the most bioavailable of the group and the most commonly used in cosmetic products. Glycolic acid differs from the other ingredients in this list in that it works by speeding-up cell turnover and removing the top layer of ‘damaged’ skin, rather than preventing melanin production. While this means users are likely to witness results faster than with other ingredients, it’s inability to suppress melanin production in the long-run, means it is usually favoured in combination with other proven ingredients rather than a stand alone treatment.
- Vitamin C, or L-ascorbic acid as it’s known in its most popular form, is already an essential skincare ingredient in the cosmetic world. Praised as an antioxidant, it mops up free radicals to protect skin from the harmful effects of sun damage and pollution. It is also essential in the formation of collagen, the natural protein that keeps skin looking young. What people may not be aware of is L-ascorbic acid can also be used in the fight against hyperpigmentation. L-ascorbic acid is a known inhibitor of the enzyme tyrosinase needed for melanin production. Unfortunately, just like kojic acid, it isn’t very stable in cosmetic products and is easily inactivated when it comes into contact with air or sunlight. This often means that many of the products on retailer’s shelves will become ineffective soon after you open the bottle or attempt to apply to the effected area. While some cosmetic brands have designed formulas that keep the L-ascorbic acid active for longer, they often come with a higher price tag.
Finally, for patients seeking stronger alternatives, its best to get down to your dermatologist. They will be able to recommend a prescription-based cream with a higher dose of one of the active ingredients listed above or perhaps an alternative procedure, such as chemical peels or laser resurfacing.