The mainstay of treatment of hyperpigmentation is topical therapy, and skincare procedures like chemical peels and dermal needling. Combining products with different modes of action gives better results.
Skin brightening or lightening ingredients target uneven skin tone, dark spots, sun spots, post inflammatory hyperpigmentation(PIH) and melasma. The results are variable from person to person and there is much ongoing research to find effective yet safe ingredients. Use of many of these products is limited by the potential for irritating the skin and in this way worsening hyperpigmentation.
The gold standard for skin lightening is hydroquinone which is only available in prescription products in South Africa. Although it is very hard to treat hyperpigmentation on the skin we look at some of the ingredients with established efficacy and list some of the skincare products available.
Kojic acid is a frequently used and well studied skin lightening agent. It is generally well tolerated in topical applications.
MOA: Kojic acid inhibits the enzyme tyrosinase decreasing the production of melanin pigment.
It is also a potent antioxidant.
Neoretin Gelcream SPF 50
This product contains Kojic acid and a sunscreen.
Neoretin booster serum
This is a lightweight, rapidly absorbed formulation containing Kojic acid and other active ingredients which inhibit melanin synthesis. Retinsphere technology increases epidermal turnover.
SkinCeuticals metacell renewal B3
Metacell Renewal B3 contains Kojic acid and other active ingredients to target the early signs of ageing and hyperpigmentation.
NeoStrata Enlighten Pigment Gel This potent formulation contains Kojic Acid, Liquorice extract, citric acid and multiple other active ingredients to target hyperpigmentation.
Liquorice extract is a natural skin lightening alternative to hydroquinone. It contains an active ingredient called glabridin, and is suitable for sensitive or rosacea prone skin as it also decreases redness and inflammation.
MOA: Liquorice extract inhibits the enzyme tyrosinase, increases epidermal turnover and is anti-inflammatory.
Lumixyl brightening crème
This gentle skin brightening product may be used while pregnant or breastfeeding. It improves the appearance of hyperpigmentation without irritation.
Citric acid is an effective product for treating several skin problems including mild acne, hyperpigmentation, blocked pores, sun damage and wrinkles. Citric acid is found in chemical peels, toners and skincare products.
MOA: Citric acid increases epidermal turnover and has antioxidant effects.
Neostrata Enlighten Pigment controller
This product is specially formulated with citric acid and retinol to target hyperpigmentation and sun spots.
Arbutin is a glycosylated hydroquinone extract. Arbutin has been considered one of the safest and most effective skin lightening agents. Its effects are optimised when combined with other substances like Vitamin C, Liquorice, glycolic acid and Kojic acid.
MOA: Arbutin inhibits the enzyme tyrosinase,decreasing the production of melanin pigment.
The active ingredient is slowly released making it suitable for those with sensitive skin.
Obagi Nu-Derm Blend FX
This product containing Arbutin penetrates deeper as the molecules are smaller. It is able to reach the basal layer of the epidermis and inhibit tyrosinase.
Obagi Nu-derm Clear FX
This light weight serum containing Arbutin targets epidermal hyperpigmentation.
Ellagic acid is a naturally occurring antioxidant found in fruits and berries that improves hyperpigmentation. It is gentle on the skin and safe to use.
MOA: Ellagic acid inhibits the enzyme tyrosinase, decreasing the production of melanin pigment.
It is safe to use on sensitive skin.
SkinCeuticals Advanced Pigment corrector
This product is formulated with ellagic acid and salicylic acid to target areas of hyperpigmentation and promote an even skin tone.
Other ingredient recommendations which have been shown to reduce melanin production include White Mulberry Extract, niacinamide, and azeleic acid
Vitamin C is a potent antioxidant which indirectly inhibits the enzyme tyrosinase leading to decreased melanin production. The anti-inflammatory effect reduces cell injury and pigment production.
Retinoic acid has many anti-ageing skin benefits. It reduces hyperpigmentation by increasing epidermal turnover.
Note from Dr. Kesiree
The management of hyperpigmentation requires a consistent and dedicated treatment routine. The results may be slow and vary between individuals. Your regimen should include preventative as well as treatment measures. Follow up your intensive treatment phases with a good maintenance regimen to maintain results.
Seek the advice of a dermatologist to assist with integrating topical treatments and skincare procedures.