What are topical lightening agents?

Topical lightening agents, as the name suggests, are creams or serums used on the skin to help lighten skin and skin pigmentation problems.

What can topical lightening agents treat?

Topical lightening agents can treat many types of skin pigmentation, including melasma, freckles, sunspots, and post-inflammatory hyperpigmentation (PIH) secondary to lasers/peels/acne.

Generally speaking, lightening agents do not completely remove pigmentation, but do significantly lighten it. Pigmentation issues such as freckles or sunspots can be completely removed with laser in most cases.

Topical lightening agents can also be used to prepare the skin for laser treatments. This reduces the risk of post-inflammatory hyperpigmentation (worsening of pigmentation) after laser treatment, especially for olive to dark skin types.

The first method of treating skin pigmentation is to prevent its appearance or worsening by daily application of sunscreen as well as sun avoidance. Then a topical lightening agent can be used in conjunction with a good sunscreen.

Common lightening agents include:What are the common topical lightening agents?

HydroquinoneThis is the most widely and successfully used skin lightening agent. It can be used for melasma or chloasma, post-inflammatory hyperpigmentation, and other disorders of pigmentation. Over the counter strengths can go up to 2%, but concentrations higher than this require a script. It can also be compounded with some of the other agents listed below by a compounding chemist. Hydroquinone can be quite irritating to the skin and cause redness or contact dermatitis when used in higher concentrations. There is also the rare risk of developing ochronosis, which is a paradoxical reaction to the hydroquinone in the treated area leading to an increase in pigmentation. This appears to occur in darker individuals after prolonged use. Alternating use of hydroquinone with other lightening agents every four months can help prevent this.

Kojic acid  –  This is derived from fungus such as Aspergillus and Penicillium. It can be used in concentrations between 1% and 4% and can be compounded with other agents.  Again, irritation can occur with use. It is not as effective as hydroquinone, but has no chance of rebound pigmentation or ochronosis.

Paper mulberry Paper mulberry extract is isolated from the roots of an ornamental tree, Broussonetia papyrifera.  A Korean study compared it to kojic acid and hydroquinone, and found that only 0.396% paper mulberry was required to inhibit the enzyme tyrosinase that produces melanin, in comparison to 5.5% hydroquinone and 10% kojic acid. Skin irritation with paper mulberry is less than other lightening agents such as hydroquinone. Paper mulberry bark can be found in Enlighten from Osmosis. 

Arbutinoriginating from bearberry, arbutin helps to lighten the skin by inhibition of the enzymes that help produce melanin. It has less irritation than kojic acid and hydroquinone. Available as L-arbutin in Cosmedix products.

Niacinamide – Niacinamide is a form of vitamin B3. It inhibits the transfer of the pigment forming cells, the melanosomes, to the surface of the skin.

Vitamin C – Topical vitamin C also helps interfere with pigment production. An additional benefit of vitamin C is the anti-oxidant effect it has, so it will help prevent skin from environmental damage. Vitamin C also stimulates the production of collagen. Stability of vitamin C is the main problem of most vitamin C products. Cosmedix  provides vitamin C in the form of L-ascorbic acid and is highly stable in this form.

Retinoids – Retinoids are derived from vitamin A. Retinoids work in a number of ways to help reduce pigmentation. The actual mechanism of action is not clear, but it is thought that their depigmenting properties arise from inhibition of the enzymes causing pigmentation, dispersion of pigment granules in the top layer of skin, and also by accelerating skin turnover to help pigmented skin cells shed more quickly. It is also this final property that helps retinoids smooth skin, reduce wrinkles, and active acne. L-retinol, a type of retinoid, is found in various Cosmedix products. Retinoids can be irritating to the skin and may need to be commenced slowly.

Combination treatments/Kligman’s formula Kligman’s formula is a combination of the above treatments formulated by a well-known dermatologist, Albert Kligman. Combining hydroquinone, dexamethasone, and tretinoin (a retinoid), it is possible to achieve a greater efficacy and minimise adverse effects. Tretinoin helps the penetration of hydroquinone, dexamethasone (a topical steroid) helps reduce the irritation from tretinoin, and tretinoin also helps reduce the skin thinning effects of dexamethosone. The doctors at The Victorian Cosmetic Institute are able to prescribe Kligman’s formula for you if appropriate. However, most of these lightening agents cannot be used during pregnancy or breast-feeding.

What is the best topical skin lightening agent for me?

This will depend on the type of pigmentation you have, the cause of the pigmentation, and your skin type ie. sensitivity, skin colour.

Many of the topical skin lightening agents are prescription only as they are quite powerful, and need to be prescribed by one of our doctors.

To make an appointment to see one of our doctors, please call 1300 863 824. Alternatively, click on the link above to ask one of our doctors a question about skin pigmentation or request a consultation online.