Skin lightening and skin whitening both refer to treatments designed for skin pigmentation removal. There is a range of skin whitening treatments, including laser, IPL & chemical peels used for hyperpigmentation treatment. Skin bleaching is a term that refers specifically to a whitening cream. Hydroquinone cream remains the gold standard for skin bleaching. However, there are other skin lightening creams. These include prescription treatments for Vitamin A and over the counter natural alternatives such as kojic acid and niacinamide. I will run through the mode of action of hydroquinone cream and other skin bleaching creams, as well as a brief overview of additional skin whitening and skin lightening therapies.
How do Skin Bleaching Creams Work?
The basis of skin bleaching is that the whitening cream must either prevent new pigment from forming in the skin or remove existing hyperpigmentation. Several different skin whitening creams operate in different ways. Most often, combinations of these are used. However, the ultimate skin whitening cream is sun protection and SPF 50+
Skin Lightening Creams that Decrease Pigment Formation.
Hydroquinone cream remains the gold standard for skin bleaching and is often combined with chemical peels to maximise skin whitening. Hydroquinone cream works by blocking proteins (enzymes) in the skin responsible for melanin production. The two essential proteins are tyrosinase and peroxidase. Other whitening creams normalise cell activity or reduce free radicals in the skin responsible for melanin production. However, most of the skin bleaching creams work by inhibiting these two enzymes. Thus, this cream remains a mainstay in melasma treatment.
Skin bleaching by blocking the enzymes that produce pigment.
There are a series of reactions that lead to hyperpigmentation in the skin. Two essential enzymes information of melanin pigment include tyrosinase and peroxidase. Therefore, a whitening cream that blocks the action of these enzymes decreases hyperpigmentation.
Prescription hydroquinone cream works by blocking the enzyme tyrosinase.
- It decreases the amount of pigment produced in the skin and helps break down existing melanin.
- Hydroquinone cream is dose-dependent and available in a low dose over the counter. However, treatment of hydroquinone 4 per cent and above are recommended.
- The side effects are also dose-dependent, so our Doctors prescribe combinations of creams to minimise side effects.
- The Main side of hydroquinone 4 % is mild inflammation to the skin
- confetti-like hypopigmentation can occur with hydroquinone cream
- ochronosis which is very rare but results when hydroquinone cream is used continuously (usually for many years). It appears as a bluish discolouration of the skin but can progress with discoloured papules.
For this reason, it is suggested that hydroquinone should never be used long term and should never be used for greater than three months in any one instance.
Naturally derived whitening creams working through the tyrosinase system.
- Arbutin is derived from leaves of different berries such as cranberry etc. It works to decrease the tyrosinase effect.
- Fungi or bacteria produce Kojic Acid. It acts by decreasing the amount of tyrosinase available to produce melanin.
Skin Lightening Creams that Remove Existing Pigmentation.
Vitamin A has its skin whitening action by increasing cell turnover and removing existing pigmentation. Similarly, chemical peels, IPL and lasers exert their skin bleaching effect by removing existing pigmentation. Therefore, it is common to combine whitening creams with therapies such as peels and IPL because they act in different ways to lighten skin pigment.
Whitening creams that decrease free radicals.
There is a group of skin lightening creams that act by decreasing inflammation. They primarily serve to reduce free radicals. Why does this have a skin whitening effect? Many forms of hyperpigmentation, such as melasma and post-inflammatory hyperpigmentation, result from skin inflammation, so they act as skin lighteners.
- Azelaic acid is known for its inhibition of melanin production
- SymWhite 377 or phenyl ethel resorcinol is an anti-oxidant that reduces inflammation and melanin production.
- Vitamin C is an antioxidant that acts in multiple ways to decrease pigment production and prevent it from depositing in the skin. However, vitamin C can be irritating.
- Niacinamide is non-irritating, anti-inflammatory. Anti-Inflammatory and decreases the deposition of pigmentation.
Vitamin A acts as a whitening cream by normalising cell activity.
Vitamin A topicals such as retinoic acid act by normalising melanin cell activity and decreasing melanin production.
Prescription Vitamin A creams remain the gold standard ( though over the counter retinol also impacts). For skin bleaching, vitamin A is often combined in a hydroquinone cream.
SPF 50+ – The Ultimate Skin Whitening Cream
Any skin bleaching regimen should include sun protection. For example, hydroquinone cream or whitening creams will have a minimal impact unless the skin is protected from the sun. This is important before, during and after skin whitening treatments.
Chemical Peels for Skin Bleaching
- applying chemical peels to the skin is another cornerstone of pigmentation treatment.
There is a range of peels available, but any that increases surface exfoliation and adds in the pigment breakdown will work. Our favourites include Jessner peel, TCA Peel and vitamin A as these are more potent and potentially work faster. Although any alpha & beta hydroxy acids increase surface peeling, these have more powerful effects.
There are areas of the body that require more care for skin bleaching. There include underarm, between legs and under the breast. Hyperpigmentation develops in these areas from friction. Regular whitening creams are too harsh, and skin whitening with a laser, IPL or chemical peels are not indicated. Special skin lightening creams are available on prescription.
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