Hyperpigmentation - How to lighten my dark spots?

Throughout my clinical practice, I have come across many clients with various skincare concerns. “What do you recommend for the dark spots on my face?” is one of the most common questions I got. Evening skin tone and reducing pigmentation are always in trend regardless of age and ethnicity. Before making any suggestion to my clients, gathering pertinent information and medical history that could potentially cause the problem is important.

What are the stimulating factors? / How does hyperpigmentation occur?

Melanocytes are skin cells that produce brown pigment (melanin) which is responsible for our skin color. If melanocytes increase melanin (pigment) production or if the number of melanocytes increase, hyperpigmentation will occur.
Medical condition such as Addison disease can cause an increase in production of melanocyte stimulating hormone. Hormonal fluctuation during pregnancy, post skin inflammation (e.g. acne scar, psoriasis and dermatitis) and UV ray exposure (sun) can contribute to increasing pigmentation of skin. Medications such as amiodarone (drug for regulating heart beat), amitriptyline, minocycline (antibiotic), chemotherapy (e.g. bleomycin, cyclophosphamide) also can cause hyperpigmentation.

Treatment

HYDROQUINONE (HQ) remains an important role. It is a skin bleaching agent that inhibits the production of melanin which gives the skin its color. 4% hydroquinone has been shown to be clinically effective and safe to use.
Glycolic acid commonly added to HQ formulation to help removing dead skin cells and thus improving the penetration of HQ into the skin. HQ cream with sunscreen +/- glycolic acid can be used twice daily or once daily in the morning.

Our clinical team’s suggestion

BiosenseClinical HQ 4% cream with sunscreen & glycolic acid	BiosenseClinical HQ 4% cream with sunscreen only
Ultraquin 4% - Cream w/sunblock SPF 20	Lustra-AF Cream SPF20

Nighttime Version

BiosenseClinical HQ 4% Cream - Plain

Ultraquin 4% - Plain Cream

Neostrata HQ Plus Gel

Recent studies have raised some question to the safety of HQ use but it is considered as safe for temporary use. Suggested duration of use is 4 to 6 months and should start taper off to minimize potential HQ resistance or ochronosis (a persistant blue-black pigmentation).

The following brightening or lightening agents are clinically proven and safe to use long term to brighten skin and correct dark spots.

• oligopeptide-68
• tetrapeptide-30
• potassium azeloyl diglycinate
• alpha-arbutin
• niacinamide (vitamin B3)
• N-acetyl glucosamine

Specialty Brightening Cream & Dark Spot Corrector

ccontains ALL these ingredients that can also be used in conjunction with HQ safely if enhancement of brightening effects is needed. Our Clinical team recommends it can be used alone safely as a long term brightening treatment and dark spot corrector.

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Lustra/Lustra AF is not available any option?

Lustra is one of the topical skin bleaching creams that contains hydroquinone (HQ) as the key ingredient. 

Hydroquinone is a clinically proven depigmenting agent that is used to lighten hyperpigmentation, or dark spots and patches, age spots, and freckles, by suppressing the melanocyte production by inhibiting tyrosinase (the enzyme that makes melanin).

Vitamins C and E and glycolic acid are also part of this formula, with Vitamin C and E possessing antioxidant effects, where as Glycolic acid acts as an alpha hydroxy acid helping to gently exfoliate and remove dead skin cell. This exfoliation process helps to enhance the absorption of hydroquinone, which allows the formula to produce greater results.

Although Lustra  is currently not available, our clinical medicinal service team has been fielding a lot of inquiries on what clients can use and what could be tailored to fit their needs. As a result, they have formulated a custom compound hydroquinone 4% in a custom formulated sunscreen moisturizing cream base with glycolic acid, Vitamin C, E and antioxidants that works as a valid option for Lustra  clients.

Instructions:

To use hydroquinone products safely and effectively, our clinical team suggests avoiding long term use, recommending that clients take about a 2 month break after 4-6 month period of use. This will help to minimize potential HQ resistance, as well as minimize the potential for adverse effects such as ochronosis (black/bluish discoloration of the skin). Due to the nature of the formula and the effects of the HQ, sun protection is a must while on HQ therapy.

For more information on HQ product,  check out: https://biosenseclinic.com/collections/custom-hydroquinone-4-related-products. Feel free to contact our clinical team for more details. 

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