HOW TO TREAT HYPERPIGMENTATION FROM SUN, SCARS, AND HORMONES
Melanin, the brown molecule that gives skin its tan color, plays an important role in protecting our DNA from the harmful effects of UV sun radiation. However, it tends to accumulate over the summer months, often in the unwanted form of sunspots or freckles, and it can even darken pre-existing skin conditions like melasma or hyperpigmented acne scars. Without treatment, these dark spots may take months to years to resolve. Read on to learn 3 nurse-recommended over-the-counter ingredients to look for on skincare labels.
A NOTE ON HYPERPIGMENTATION
Before we discuss the following 3 ingredients, it is important to note that hyperpigmentation is one of the most complex and stubborn conditions to treat in aesthetic dermatology, sometimes requiring several adjustments to the treatment plan. Thus, if over-the-counter therapy doesn’t appear to be working for you (which is common), you should begin a patient-provider relationship with a licensed professional who can review your progress every 1-3 months.
- KOJIC ACID
Kojic acid is one of the most effective over-the-counter skin-brightening ingredients on the market. This molecule was first isolated in Japan from steamed fermented rice (called “Koji” in Japanese.) Clinical studies have shown that kojic acid acts by inhibiting the principal enzyme in melanin synthesis. This action is the same as that of hydroquinone, the gold standard in prescription-grade hyperpigmentation therapy (see our “Hyperpigmentation Part II” post for more thoughts on hydroquinone). While kojic acid has long been the most popular skincare ingredient in Eastern Asia for treating melasma, it has more recently gained popularity in the US for all types of pigmentary conditions. It is important to note is that kojic acid has been known to cause skin sensitivity in some individuals, and should be decreased or discontinued if redness or irritation occur.
Clinical trials using 2% niacinamide have shown that it significantly reduces the total size of hyperpigmented areas and lightens baseline skin color after 4 weeks of treatment. Niacinamide’s action is to block the transfer of melanin from the base skin layer where it is synthesized by the body, to the superficial layer that gives us our skin color. Niacinamide also has anti-inflammatory properties, prevents water-loss from the skin, and is very stable in formulation, so overall it is considered very useful by skincare chemists and can be found in a wide array of cosmeceuticals.
3. LICORICE EXTRACT
Licorice extracts, derived from the roots of licorice plants, are the safest over-the-counter pigment-lightening agents with the fewest side effects. The active agents in licorice extract are known as glabridin and liquiritin. Glabridin acts similarly to kojic acid, in that it inhibits the principal enzyme in melanin synthesis, and liquiritin facilitates dispersal and removal of melanin by the body. Additionally, licorice extract has anti-inflammatory properties which aid in reducing any redness or irritation.
These 3 ingredients are all well-studied with superb safety profiles, hence why they are all available over-the-counter at your local sephora or department store. However, these ingredients cannot be compared to prescription grade ingredients which are by far the most clinically-effective at reducing pigmentation. See our next blog post for part 2 of 3 on hyperpigmentation: “3 of the Best Prescription-Strength Dark Spot Creams According to a Nurse”.