Treating Hyperpigmentation and Melasma: Part 2
Today, Dr. Jo will continue her discussion of specific products used to treat melasma and hyperpigmentation.
Dr. Jo Herzog, M.D.
Last week, we began a discussion on treating hyperpigmentation, and this week we will discuss some of the products that your dermatologist or other physician might prescribe for you. The are countless products available, and my list is certainly not exhaustive. I am just sharing information on several products that you might want to consider.
First, I would encourage you to be careful about buying products online and using them without proper instruction from your physician. Also, be careful about buying products from foreign countries, as they might not be as well regulated and might contain ingredients that we do not consider safe.
When ordering online, keep in mind that regulations might vary in different areas. For instance, some states and countries have deemed hydroquinone unsafe and have pulled it from the market. As I said last week, my personal opinion is that hydroquinone is safe when used for short periods of time and only when needed.
One of the products we discussed last week, hydroquinone, can be bought as a single component cream or combined with many other products for a more comprehensive treatment of hyperpigmentation. This medication is available over the-counter in a cream, but strengths of 4% or more are supposed to require a prescription.
Creams containing a combination of hydroquinone and other products include Triluma (not currently available), Lustra family of products (difficult to get now), Clinicians Complex (multiple products), Neocutis Blanche, SkinTx Clarite, Vivier Seequin, Obagi Nu Derm Blender and many others.
Some of these product lines come with kits that include cleanser, toner, sunscreens, etc. We will talk more about kits at another time, but for now, I will say that the HQ containing component in a kit is most active in “bleaching,” and the sunscreen component is most important for prevention of discoloration.
Many physicians compound their own “triple” hydroquinone products for their patients while others sell or prescribe pre-packaged formulations. Most contain 4-6% HQ, tretinoin(retin A), and 1% hydrocortisone as their basic active ingredients. These three products work in unison for optimal results. This is my favorite first line treatment for melasma.
Non HQ containing products my be preferred by those worried about HQ or by pregnant moms. They can also be used between HQ rotations. Some name brands include Pro + Therapy, some PCA products, Vivite Vibrance (not Vivier), White Lightening by iS Clinical, Aveeno Skin Brightening moisturizer, Whiteplex, Celebright, Revitol, etc. There are literally hundreds of these products on the market. Many have “good” active ingredients, but to make sure you choose a quality product, it always helps to get a doctor’s recommendation.
My top picks would be to use a combination therapy that rotates creams as per your dermatologist, especially if you are willing to use a HQ for a limited time. If you do not want to use HQ with a retinoid (tretinoin) and want an OTC treatment all of the above are reasonable choices.