Hyperpigmentation: Looking beyond hydroquinone

Charoo, Naseem A.

doi:10.1111/jocd.14746

Cited by 21 publications

(14 citation statements)

References 74 publications

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“…Melanocytes are some of the most fragile cells, with high sensitivity to temperature and toxins. Many ingredients like hydroquinone that claim to decrease pigment production may actually be melanotoxic 13 . The multimodal tranexamic acid, niacinamide, hexylresorcinol, and licorice combination does not possess these safety issues.…”

Section: Discussionmentioning

confidence: 99%

The clinical benefit of a multimodal topical approach to treating skin dyspigmentation

Draelos

Dı́az

2023

J of Cosmetic Dermatology

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Background The recent removal of hydroquinone from the over‐the‐counter market has created a need for modern skin lightening formulations. An effective pigment lightening formulation must be non‐irritating to prevent skin darkening from post‐inflammatory hyperpigmentation, penetration enhanced to reach the epidermal/dermal junction, contain anti‐inflammatory ingredients, and address multiple mechanisms of pigment production. Objective The objective of this research was to demonstrate the efficacy of a topical multimodal pigment lightening preparation containing tranexamic acid, niacinamide, and licorice. Methods Fifty female subjects 18+ years of all Fitzpatrick skin types with mild to moderate facial dyspigmentation were enrolled. Subjects were provided with the study product for twice daily use on the entire face and an SPF50 sunscreen with evaluations occurring at Week 4, Week 8, Week 12, and Week 16. The investigator used a face map to identify a pigmented target site on the face for dermaspectrophotometer (DSP) measurement. The dermatologist investigator completed a baseline facial efficacy and tolerability assessment. The subjects completed a tolerability assessment. Results 48/50 subjects completed the study without tolerability issues. The DSP readings demonstrated a statistically significant reduction in target spot pigmentation at Week 16. The investigator assessed a 37% decrease in pigment intensity, a 31% decrease in pigment extent, a 30% decrease in pigment homogeneity, a 45% improvement in brightness, a 42% improvement in clarity, and a 32% improvement in overall facial skin dyspigmentation at Week 16. Conclusion The combination of penetration enhanced tranexamic acid, niacinamide, and licorice was effective in inducing facial pigment lightening.

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Section: Discussionmentioning

confidence: 99%

The clinical benefit of a multimodal topical approach to treating skin dyspigmentation

Draelos

Dı́az

2023

J of Cosmetic Dermatology

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“…Hydroquinone is usually used in topical form and it is sold under different brand names like Melamin®, Nuquin® and many others. 68 By incorporating hydroquinone into ethosomes, the drug can be delivered directly to the melanocytes, the cells responsible for producing melanin, leading to improved efficacy and reduced side effects. Hydroquinone ethosomes is not a drug that is available in the market.…”

Section: Ethosomes For Skin Whiteningmentioning

confidence: 99%

Unlocking the potential of cosmetic dermal delivery with ethosomes: A comprehensive review

Abu‐Huwaij

Zidan

2023

J of Cosmetic Dermatology

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BackgroundIn a world where hair loss, acne, and skin whitening are common concerns, ethosomes emerge as a captivating breakthrough in cosmetic drug delivery.MethodThis review provides a comprehensive overview of the ethosomal system and assesses its potential as an effective nanocarrier for delivering active ingredients to the skin. The focus is on exploring their applications in various pathologies, particularly skin disorders such as acne, hair loss, and skin pigmentation.ResultsEthosomes are a novel type of vesicular nanocarrier composed of high concentrations of ethanol (20‐45%) and phospholipids. Their unique structure and composition make them an ideal choice for transporting active ingredients through the skin, offering targeted and effective treatment. The inclusion of ethanol in ethosomes' composition gives them distinctive properties, including flexibility, deformability, and stability, facilitating deep penetration into the skin and enhancing medication deposition. Moreover, ethosomes improved theoverall drug‐loading capacity, and specificity of target treatmentConclusionEthosomes represent a unique and suitable approach for delivering active cosmetic ingredients in the treatment of hair loss, acne, and skin whitening, presenting a versatile alternative to traditional dermal delivery systems. Despite the challenges associated with their complex preparation and sensitivity to temperature and humidity, the remarkable potential benefits of ethosomes cannot be ignored. Further research is crucial to unlock their full potential, understand their limitations, and refine their formulations and administration methods. Ethosomes hold the promise of transforming the way we address these cosmetic concerns, offering an exciting glimpse into the future of advanced skincare solutions.

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“…This has significant implications for the treatment of melasma given the common use of OTC agents containing HQ. 46,47 Triple combination therapy with HQ 4%, tretinoin 0.05%, and fluocinolone acetonide 0.01% is the only FDA-approved topical for the treatment of melasma and is considered the gold standard of treatment. This triple combination cream (TCC) is a modification of the Kligman-Willis formula that combined HQ with a retinoid and topical corticosteroid for the treatment of hyperpigmentation.…”

Section: Prescription-based Therapiesmentioning

confidence: 99%

“…Most recently, in 2020 legislation in the CARES Act (The Coronavirus Aid, Relief, and Economic Security Act) led to the withdrawal of over‐the‐counter (OTC) 2% HQ from the US market due to the determination that HQ is not classified as “generally recognized as safe and effective (GRASE)” by the FDA. This has significant implications for the treatment of melasma given the common use of OTC agents containing HQ 46,47 …”

Section: Topical Therapiesmentioning

confidence: 99%

Melasma hyperpigmentation: An overview of current topical therapeutics

AlSalem

Alexis

2022

Dermatological Reviews

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Background Melasma is a common disorder of hyperpigmentation that affects populations globally and can adversely affect quality of life. Topical therapies—including hydroquinone and nonhydroquinone‐containing formulations—play a central role in the management of melasma. Methods A literature review was conducted using PubMed and Google Scholar. Search keywords included a combination of the following: “melasma,” “chloasma,” and “topical treatment.” We identified and included seminal and high‐quality peer‐reviewed publications, systematic reviews, randomized controlled trials, case series, case reports, consensus statements, and expert opinions. Results Topical therapies are widely used for the treatment of melasma. Triple combination cream containing hydroquinone, fluocinolone, and tretinoin is the most studied formulation with the strongest evidence among treatment options. Numerous other prescription‐based and nonprescription topical agents, including a growing list of cosmeceuticals, have been used in the treatment of melasma, albeit in smaller studies. Conclusion A growing range of topical agents is available for the treatment of melasma. While larger, more robust studies are warranted, nonhydroquinone cosmeceuticals may be useful adjuncts or alternatives to the gold standard of triple‐combination hydroquinone cream.

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Hyperpigmentation: Looking beyond hydroquinone

Cited by 21 publications

References 74 publications

The clinical benefit of a multimodal topical approach to treating skin dyspigmentation

The clinical benefit of a multimodal topical approach to treating skin dyspigmentation

Unlocking the potential of cosmetic dermal delivery with ethosomes: A comprehensive review

Melasma hyperpigmentation: An overview of current topical therapeutics

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