Skin Lightening Agent

If you have hyperpigmentation, where parts of your skin are darker than the rest of your overall skin tone, you may have heard of countless therapies available for lightening those dark patches of skin.

It's not uncommon to hear about the benefits of chemical peels and vitamin C serums in evening out your skin tone, fading acne scars and treating age spots. But, there's one treatment that tends to fly under the radar and it is actually considered the best way to deal with pigmentation by doctors.

What is a skin lightening agent?

Skin-lightening agents are used to fade dark spots and even out skin tone [1]. Dermatologists consider it the gold standard treatment for hyperpigmentation as it is quick to work and highly effective.

It typically comes as a cream or lotion formula for topical use and is used to treat common skin conditions like post-inflammatory hyperpigmentation (dark spots left on your skin after pimples or injury), age spots and facial melasma.

How do skin lightening agents work?

Because of its skin lightening effects, this treatment is commonly referred to as a skin bleaching cream. If you've ever bleached your hair or used bleach in your laundry, you might imagine that a skin bleaching cream works in the same way and removes pigment from your skin.

However, this is not what it does. Melanin is the pigment that gives our skin its colour and what this treatment does is slow down the production of melanin and even out skin tone over time [1].

You typically use it as a spot treatment, applying it in a thin layer and gently massaging it into the affected areas twice daily for around three months.

With consistent use, this agent can significantly fade hyperpigmentation, even to the point of being unnoticeable.

Treating melasma

If you have dark patches on your face — usually appearing around the forehead, cheeks, upper lip and side of the nose — you may have melasma. This is a common skin concern, particularly among women between 20 to 40 years of age, and it often occurs appears in pregnancy.

People who tan easily in the sun or have darker skin tones are more likely to be affected by melasma.

A clinical-strength treatment is effective in minimising the visibility of melasma, with 70 per cent of patients using it noticing a reduction or disappearance of melasma within three months [1].

What happens when you stop using a topical cream?

The nature of this ingredient means you should take regular breaks from using it. In fact, many healthcare providers ask their patients to take a break after three to six months of use [2].

Pausing the treatment not only reduces your risk of a rare side effect, but after a few months, your skin gets used to it. This means that the improvement to dark spots can stop, while the skin around the affected area continues to lighten.

Stopping the use of these creams gives your skin time to stabilise. Although this treatment is undoubtedly effective in lightening melasma, it is possible for the dark spots to return after stopping the treatment, especially with sun exposure [1].

This is one reason why it is so important to wear sunscreen every single day — especially if you're prone to hyperpigmentation. Your practitioner will advise you on whether you should use your treatment again or if a different course of action would be better.

Does it thin the skin layer?

The treatment itself does not lead to skin thinning. However, multiple studies have found that it achieves optimal results when combined with retinoids and topical steroids [2].

In some cases, a skin lightening agent can be used in formulas that feature steroids, which is what can thin the skin when used for a prolonged period of time [3][4].

This is another reason why it's important to stop using your treatment after a while, as directed by your healthcare professional. Giving your skin a break will prevent it from thinning.

Alternatively, you can also discuss customising your formula to not include topical steroids with your practitioner.

What are the side effects?

This treatment is generally safe, however, there are a few adverse effects to be conscious of. However, most of them are mild or preventable by following the directions from your healthcare professional.

This skin lightening ingredient can cause some mild irritation such as redness, inflammation, rashes and stinging [2]. People with sensitive skin may even experience contact dermatitis and this is why including a topical steroid alongside it in a cream can be beneficial [1].

Otherwise, it can also be helpful to incorporate a soothing product into your skincare routine, like Software's Ceramide Repair Balm, which is designed to calm irritated skin. Alternatively, you may wish to take a break from using the product.

Another common side effect associated with the use of skin lightening agents is increased sun sensitivity. To reduce your risk of burning and other skin damage, avoid excessive sun exposure, wear sunscreen and cover up with protective clothing.

Prolonged use of this ingredient can also cause discolouration of the fingernails. You can help prevent this by washing your hands straight after applying the cream.

The most serious side effect of skin lightening agents is exogenous ochronosis. This is a blue-black discolouration of the skin that results from misuse. It normally comes about after excessively using it for months or years while also engaging in lots of sun exposure.

Exogenous ochronosis needs to be treated with lasers, so it's best to follow the recommended instructions and not go rogue with this product in order to avoid needing to treat this side effect.

Skin lightening agents and niacinamide

A good skincare routine relies on ingredients that complement each other, and this duo does just that.

Niacinamide, also known as vitamin B3, is often used in skincare products to improve skin barrier function, reduce inflammation and redness, and improve fine lines and wrinkles. It can also help fade dark spots.

The merits of niacinamide make it a great accompaniment in a skin pigmentation treatment plan as it helps to soothe any side effects of the other treatment while also providing the added benefits of skin lightening.

One clinical trial asked 27 melasma patients to apply niacinamide on one side of their face, and skin lightening agents on the other side for eight weeks. At the end of the study, 44 per cent of participants found that the niacinamide cream had produced positive results in lightening their melasma [5].

On the other side, 55 per cent of participants had positive results using skin lightening treatment. Although it performed a bit better in terms of skin lightening, another interesting observation from this study was that niacinamide produced less side effects.

18 per cent of participants reported side effects from niacinamide compared to 29 per cent from skin lightening agents [5].

The lower risk of adverse effects means that niacinamide could be an alternative treatment during the periods where you need to take a break from the product.

Skin lightening agents are powerful and should be used under the guidance of a health practitioner for best results.