Means that reduce pigmentation (bleaching)

Means that reduce pigmentation, or bleaching, are widely used in hyperpigmentation of various genesis: melasma (chloasma), lentigo, freckles, post-inflammatory pigmentation and other conditions.

Ideal bleaching and the drug should have quite pronounced depigmenting properties and do not cause side effects. Presently available potent whitening agents cause a number of side effects, which should always be remembered by a specialist.

To the bleaching agents include the following agents: hydroquinone and its derivatives, topical retinoids, azelaic acid, benzoyl peroxide, topical glucocorticoids, ascorbic acid, hydroxy acids and other drugs.

Hydroquinone and its derivatives (monobenzyl ether hydroquinone, etc.) are the strongest bleaching agents. The bleaching effect is associated with the slowing down of the formation of melanosomes, the acceleration of their degradation processes, the slowing down of the synthesis of RNA and DNA in melanocytes. In a number of European countries, a 2-5 (10%) solution or emulsion (cream) of hydroquinone is used. Assign 1 time per day, at night, for a period of 5-7 weeks. Quite popular combination drugs, including hydroquinone and topical retinoids, corticosteroids, various acids. Side effects include a high incidence of allergic dermatitis, irritant effect (simple dermatitis), hyperpigmentation, confetti-like leukoderma. Emphasize that monobenzyl ether hydroquinone more often causes side effects, compared with hydroquinone. Due to the high frequency of side effects in our country are not currently used.

Topical retinoids reduce pigmentation due to the effect of melanogenesis processes in melanosomes, on the one hand, and the acceleration of the rate of renewal of the epithelium bed, on the other. Traditionally, retinoids are used for external acne therapy. Tretinoin and isotretinoin (0.025-0.1%) have previously been used with the bleaching agent; 0.1% adapalene {Differin, gel, cream) can now be used. Topical retinoids are prescribed 1 time per day, at night, for a long time (up to six months). Currently, retinoids are part of masks and peeling agents (for example, "yellow peeling"). Side effects of retinoids include their irritating effect.

Azelaic acid is also an external drug for the treatment of acne. Depigmenting action is associated with a decrease in the activity of the tyrosinase enzyme and the ability to slow the proliferation of pathologically altered melanocytes. Assign in the form of 20% cream (Skinoren, cream) 1-2 times a day for a long time (at least six months). Azelaic acid as a whole is well tolerated, it can rarely give a slight annoying effect.

Benzoyl peroxide is also used for external treatment of acne, especially pustular. The bleaching effect is due to the fact that benzoyl peroxide decolours melanin due to its oxidation, and also has an exfoliating action. Use 2.5-10% benzoyl peroxide in the form of a gel, emulsion, solution (for example, Baziron AS, 5% gel). Of the side effects possible simple dermatitis, extremely rarely allergic dermatitis.

Topical glucocorticoids have a bleaching effect due to a slowing down of melanin synthesis in melanosomes and a decrease in the inflammatory response. Used extremely rarely, only in combination with topical retinoids, hydroquinone and other bleaching agents. Do not recommend the use of fluorinated glucocorticosteroids, as well as any drugs from this group on the face. Side effects include atrophy of the skin, activation of bacterial, mycotic and viral infections, development of steroid (perioral) dermatitis.

Ascorbic acid not only suppresses the production of melanin at various stages of melanogenesis, but also facilitates the transformation of eumelanin into leukomelanin. Assign a concentration of up to 10%, 1-2 times a day, for a long time (at least six months), sometimes in combination with other means. It is part of some professional peelings.

Hydroxy acids (alpha, beta, polyhydroxy acids) are widely used in cosmetology for peelings, one of the goals of which is the reduction of unwanted pigmentation. The bleaching effect is mainly associated with a decrease in the activity of tyrosinase and the acceleration of the change in the epithelial layer. Most hydroxy acids are of natural origin. The most commonly prescribed glycolic, lactic, malic, malic, salicylic and other acids. The concentration and pH depend on the desired depth of exfoliation.

On the cosmetic market, new compounds constantly appear to reduce the intensity of pigmentation. In particular, 4-butyl-resorcinol (Rucinol) not only inhibits tyrosinase, but also inhibits the activity of the TRPI enzyme involved in the synthesis of eumelanin. Rucinol is included in the ovary of serum and cream Iklen ("MERC Medicaçon Familial", France). In recent years, began to use the derivative of licorice - glabridin. This substance is included in a variety of bleaching scales, as well as with a preventive purpose in sunscreen products (brand "Bioderma"). Currently, the old, previously popular, method of bleaching the skin with drugs containing white prepitpitic mercury, due to the high risk of developing allergic dermatitis, is hardly ever used. It should also emphasize the need for effective photoprotection against the background of treatment of hyperpigmentation of any genesis.

[1], [2], [3], [4], [5]