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 information.

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 Clinical Dermatology.
SOURCE: (September-October 2000, pages 261-268)

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."
SOURCE: http://www.cosmeticscop.com/learn/

Among 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.
SOURCE: http://www.emedicine.com/derm/topic528.htm

Skin-whitening 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.

http://www.nytimes.com/2006/05/14/world/asia/14thailand.html?ex=1305259200&en=58475681dbd045a9&ei=5088&partner=rssnyt&emc=rss


Kojic Acid


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 307–311). Glycolic or kojic acid, or glycolic acid with hydroquinone, are highly effective in reducing the pigment in melasma patients.
SOURCE: http://www.cosmeticscop.com/


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.

Source: Dermatological Surgery, June 1999, pages 450-454
SOURCE: http://www.cosmeticscop.com/learn/

Hydroquinone

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 hydroquinone?

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.

Please read 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 physician.

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

Hydroquinone 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 discolorations.
(Sources: Journal of Cosmetic Science, May-June 1998, pages 208-290; Dermatological Surgery, May 1996, pages 443-447).

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).

H
ydroquinone 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.
SOURCE: http://www.cosmeticscop.com/

Magnesium ascorbyl phosphate

Magnesium-L-ascorbyl-2-phosphate (MAP) is a stable derivative of ascorbic acid. When used as a 10% cream, MAP was shown to suppress melanin formation. A significant lightening effect was seen clinically in 19 of 34 patients with melasma and solar lentigos. Furthermore, MAP has been shown to have a protective effect against skin damage induced by UV-B irradiation. The latter protective effect is because of the conversion of MAP to AS.
SOURCE: http://www.emedicine.com/derm/topic528.htm

Tretinoin

Results can also take far longer with tretinoin than with other treatments, requiring at least six months or so before improvement is seen.
Because of this, tretinoin is generally not recommended as the only option for skin discoloration but it can be used in combination with other effective topicals (source: eMedicine Journal, www.emedicine.com, November 15, 2001, Volume 2, Number 11). Even though tretinoin can be disappointing for skin lightening, that should in no way diminish the role it plays in the improvement in skin"s cell production, collagen production, elasticity, texture, and dermal thickness. Tretinoin, combined with more effective skin-lightening treatments, is a powerful alliance in the battle against sun-damaged and aged skin.
SOURCE: http://www.cosmeticscop.com/learn/article.asp?PAGETYPE=ART&REFER=SKIN&ID=25 

 
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