Hydroquinone Alternatives for Skin Lightening

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For a very long time hydroquinone has been the mainstay of treatment for melasma and other forms of hyperpigmentation (areas of darker skin).

However, concerns about the safety of hydroquinone have developed over the last few years, so there is a growing interest in developing alternative skin lightening therapies. Some of these alternatives have been available for a long time and include the following:

  • Kojic acid. This agent. derived from a fungus. inhibits the production of melanin, the pigment that gives skin its dark color.
  • Soy
  • Arbutin, another plant extract.
  • Niacinamide. This is a B-vitamin compound that is the active ingredient in some acne medications, but it’s got some reputation for being a skin-lightening agent too.
  • Azelaic acid, the active ingredient in some rosacea medications, a has some skin-lightening effect.
  • Lumixyl is a peptide that’s been around for a couple of years. It’s also made from a mushroom extract and it actually blocks the production of melanin. It is categorized as tyrosinase inhibitor and acts similarly to hydroquinone. In studies it’s shown to be a lot more effective at blocking that pathway than even hydroquinone and it’s less toxic than hydroquinone. Clinically it seems to be effective and probably a little less irritating.
  • Melaplex is a compound that’s in another skin care line that’s used for brightening the skin.
  • Elure is an enzyme that breaks down the existing melanin that’s been deposited in the skin. It’s works differently than the other agents as those either prevent the production of melanin or the transfer of melanin into the skin. Because of its different mechanism, it may be combined with other bleaching agents.
The challenge with treating hyperpigmentation is that even if you can block the creation of new melanin (pigment), the existing melanin takes a long time to clear from the skin. So a variety of other treatments may be used to remove the existing pigment, including:
  • Chemical peels. These increase the turnover of the top layer of the skin (epidermis) and drive the melanin out of the skin more rapidly.
  • Retin-A and other forms of topical retinoids are also effective because it helps increase the turnover of the skin cells.
  • Fractional ablative lasers create tiny holes in the top layers of the skin, and through these channels, pigment gets quickly removed from the skin.
So, the treatment of hyperpigmentation requires multiple stages. You need to block the production or transfer of new melanin, if you can, and then remove any existing pigment that’s still in the skin.
Treating melasma is particularly difficult as the pigment that causes the dark patches of melasma always comes back, regardless of which method you use. You can try to block it, but we know that melasma is partially driven by sun exposure and partially driven by hormonal factors. The hormonal factors are very difficult to control. We always find that it comes back no matter what. So the treatment is either a chronic one or an episodic treatment. Many of my patients come in twice a year or once a year to have lasers or procedures to remove the existing pigment.

Sunscreen is really essential for the treatment of melasma and other forms of hyperpigmentation because we know that UV radiation drives the production of melanin (pigment). So you should try to do everything to block the UV rays. That includes using sunscreen and reapplying often, avoiding direct sun exposure between ten and four o’clock, and wearing hats and seeking shade and wearing sunglasses.
Article by
Naperville Dermatologic Surgeon