Treating Skin Discoloration

Effective Ingredients to Look For

Unevenness of skin tone is the number one complaint from women. There are dozens of products to help with discoloration, which often make promises that can’t be kept. Unfortunately, even the best products will take two to three months before improvement is noticed. I will highlight some of the key ingredients to look for so that you can be your own skin-care expert.

Treating Skin Discoloration

Brown spots on the face generally are a result of three factors:

1.The sun: sun spots (large looking speckled freckles called lentigines).

2. After trauma: Post-inflammatory hyperpigmentation, a condition in which an injury or inflammation attracts pigmentation to the area when the condition resolves (i.e., acne, rash, trauma).

3. Hormones: Melasma may occur during pregnancy or with birth control pills and presents as large brown patches over cheeks and forehead.

The quickest way to treat sun spots is with an Intense Pulse Light device, IPL or “photofacial.” This device may make the other two causes of pigmentation worse, as these are caused by inflammation and can unpredictably darken from any irritation to the skin.

All types of discoloration have one thing in common— strict sun protection and avoidance are mandatory. No matter the cause of your discoloration, those pigmented cells are programmed to darken immediately with ultraviolet light and heat. You may spend a month successfully evening out your complexion and one day in the sun will ignite those pigment cells to fire up and darken. So, seek shade, enjoy the outdoors early and late in the day, wear a wide-brimmed hat and apply a sunscreen with SPF 30-plus with zinc oxide every single morning. My favorite daily sunscreens are EltaMD Physical, Daily or Clear.

Lightening agents to look for include:

1. Hydroquinone: Inhibits pigment (melanin) formation. The most widely available ingredient with 2 percent strength over the counter and 4 percent through a dermatologist. Hydroquinone works well, but has been under scrutiny for questionable health risks with long-term, widespread use. Risks include allergy, skin irritation and potential to darken skin. It is best to use for two- to three-month bursts and use a safer alternative the rest of the time. It is not safe to use during pregnancy.

2. Arbutin:
A natural form of hydroquinone derived from plants, including bearberry, blueberry, mulberry and cranberry. Has similar mechanism and effects as hydroquinone with better safety profile.

3. Kojic acid: Antioxidant that works by breaking down the pigment in the skin and preventing its production. May cause skin irritation and is unstable in many formulations.

4. Licorice (glabridin): Non-toxic and slows pigment production, and is anti-inflammatory.

5. Glutathione: An antioxidant that inhibits pigment production. Difficult to absorb into cells, it is enhanced with vitamin C or E. N-acetyl cysteine orally will also boost its level.

6. Niacinamide: A form of vitamin B3 that inhibits the transfer of pigment to the skin’s upper layer. Also anti-inflammatory, reduces acne and increases skin moisture.

7. Azelaic acid: Also works for acne and selectively works on overactive melanocytes so it won’t affect normal pigment on skin.

8. Vitamin C: An antioxidant, also protects from sun damage but is unstable.

Penetration of these lightening agents will be enhanced if you apply a product that will exfoliate and loosen the bonds of the top layer of the skin. Plus, exfoliation will provide a healthy glow to skin and remove those top layers containing old pigmentation. Look for products containing retinol and glycolic acid.

Avoiding sugar is also helpful in controlling skin discoloration, as a sugar molecule is needed in pigment production. Other dietary changes, which may assist, include consuming foods with carotenoids and vitamin C.

Jennifer Haley, MD, FAAD

Jennifer Haley, MD, FAAD is a board-certified dermatologist with a degree in Nutrition Science from Cornell University. She has been an NPC bikini competitor and a consultant to the US Capitol. She enjoys an active lifestyle in Scottsdale, AZ and Montrose, CO with her husband and three boys.