BEAUTY AGENTS AND TREATMENTS
Even with all the products manufactured, they all still use several
basic ingredients, all of which work to a degree. As you"ll read
further down, some have side effects, and some work better for some
skin types that others. Your best source of information however, would
be a dermatologist, who can examine your skin and help you select the
best product for you. We collected quite a few info from different sites that explain the
different products; pros and cons. Please check each link for complete
When it comes to selecting
treatment for these areas, one factor to consider is the depth of the
discolored pigment. Most of the time discoloration is superficial. In a
few cases, the discoloration lies deep in the dermis. If the pigment is
in the epidermis, it can be helped with skin-lightening products. If
the pigment is deeper, laser treatments are a consideration. For
topical treatments, according to an article in The American Journal of
SOURCE: (September-October 2000, pages
Topical hydroquinone 2 to 4% alone or in combination with
tretinoin 0.05 to 0.1% is an established treatment. Topical azelaic
acid 15 to 20% can be as efficacious as hydroquinone. Tretinoin is
especially useful in treating hyperpigmentation of photoaged skin.
Kojic acid, alone or in combination with glycolic acid or hydroquinone,
has shown good results, due to its inhibitory action on tyrosinase.
Chemical peels are [also] useful to treat melasma."
skin-lightening agents, hydroquinone (HQ) is one of the most widely
prescribed agents in the world. However, with reports of potential
mutagenicity and epidemics of ochronosis in African nations, there has
been increasing impetus to find alternative herbal and pharmaceutical
depigmenting agents. A review of the literature reveals that numerous
other depigmenting or skin-lightening agents are in use or in
investigational stages. Some of these, such as kojic and azelaic acid,
are well known to most dermatologists. Others more recently have been
discovered and reported in the literature.
The 2% HQ is readily
available over-the-counter in various cosmetic preparations. However,
for better efficacy, it often is compounded into various mixtures for
treatment of hyperpigmentation. The original Kligman formula involves
compounding 5% HQ with 0.1% retinoic acid and 0.1% dexamethasone in a
hydrophilic ointment base. Concentrations as high as 10% can be
compounded extemporaneously for refractory cases. Evidence of
improvement with HQ (monotherapy) usually is observed at 4-6 weeks,
with improvement appearing to plateau at about 4 months. Despite its
remarkable overall safety, the physician ought to bear in mind the
potential adverse effects. Contact dermatitis occurs in a small number
of patients and responds promptly to topical steroids. An uncommon, yet
important, adverse effect of HQ is exogenous ochronosis. This disorder
is characterized by progressive darkening of the area to which the
cream containing HQ is applied. Histologically, degeneration of
collagen and elastic fibers occurs. This degeneration is followed by
the appearance of characteristic ochronotic deposits consisting of
crescent-shaped, ochre-colored fibers in the dermis.
products work in various ways. Some contain acids that remove old skin
to reveal newer, lighter skin underneath. Others inhibit melanin, like
those with mulberry extract, licorice extract, kojic acid, arbutin and
hydroquinone, an ingredient in prescription creams for blemishes as
well as in photo processing materials. Some of the most effective
agents are also risky and are often the least expensive, like
mercury-based ingredients or hydroquinone, which in Thailand sells for
about $20 per kilogram (2.2 pounds), compared with highly concentrated
licorice extract, which sells for about $20,000 per kilogram.
Hydroquinone has been shown to cause leukemia in mice and other
animals. The European Union banned it from cosmetics in 2001, but it
shows up in bootleg creams in the developing world. It is sold in the
United States as an over-the-counter drug, but with a concentration of
hydroquinone not exceeding 2 percent.
Kojic acid is a by-product in the
fermentation process of malting rice for use in the manufacturing of
sake, the Japanese rice wine. There is convincing research, both in
vitro (in a test tube) and in vivo (on a live subject), showing kojic
acid to be effective for inhibiting melanin production (Source:
Archives of Pharmacal Research, August 2001, pages 307â€“311). Glycolic
or kojic acid, or glycolic acid with hydroquinone, are highly effective
in reducing the pigment in melasma patients.
Alpha Hydroxy Acids
Alpha hydroxy acid products in concentrations of 4% to 10%
are not effective for inhibiting melanin production and won"t lighten
skin discolorations. However, there is evidence that in combination
with other treatments such as kojic acid, hydroquinone, azelaic acid,
and laser resurfacing they can be very effective for improving the
overall appearance of sun-damaged skin and possibly helping the other
ingredients penetrate the skin better. Much like laser treatments,
alpha hydroxy acid peels (using 50% concentrations) have impressive
results for removing skin discolorations.
Only a physician should perform
these types of facial peels.
Surgery, June 1999, pages 450-454
Hydroquinone is a common skin bleach, intended to fade age
spots and small skin discolorations. Some products that contain
hydroquinone Eldopaque, Eldopaque Forte, Eldoquin-Forte Sunbleaching,
Esoterica Facial, Esoterica Regular, Esoterica Sunscreen, Melquin
HP, NeoStrata AHA Gel for Age Spots and Skin Lightening, Nuquin HP,
Solaquin, Solarquin Forte.
What drug(s) may interact with
Benzoyl peroxide Check with your prescriber if you
are using other medications which are applied to the skin.
Non-medicated cosmetics, sunscreens, and moisturizing lotions may be
worn over the hydroquinone preparation. However, wait several minutes
after application of hydroquinone before applying them.
the entire site for further information. http://www.drugdigest.org/
Over-the-counter skin-lightening products often contain 2%
hydroquinone, while 4% concentrations are available only from a
Hydroquinone is a strong inhibitor of melanin
production), meaning that it lightens skin color.
(source: Journal of Dermatological Science, August, 2001,
Supplemental pages S68-S75
does not bleach the skin (calling it a bleaching agent is a misnomer);
it only disrupts the synthesis of melanin hyperpigmentation. In the
medical literature Hydroquinone is considered the primary topical
ingredient for inhibiting melanin production.
Using it in
combination with the other options listed can make a difference in skin
(Sources: Journal of Cosmetic Science, May-June
1998, pages 208-290; Dermatological Surgery, May 1996, pages
Some concerns about hydroquinone"s safety on skin have been
expressed, but the research indicates reactions are minor or a result
of using extremely high concentrations.
(Source: Critical Reviews in
Toxicology, May 1999, pages 283-330).
Hydroquinone can be an
unstable ingredient in cosmetic formulations. When exposed to air or
sunlight it can turn a strange shade of brown. It is essential, when
you are considering a hydroquinone product, to make sure it is packaged
in a non-transparent container that doesn"t let light in and minimizes
air exposure. Hydroquinone products packaged in jars are not
recommended, because they become ineffective shortly after opening.