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:a brief review of
Hyperpigmentation treatment strategy in cosmetic field
by :
Dr Mohammad Baghaei COSMETIC SCIENTIST
MECSCC PRESIDENT OF
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Hyperpigmentation occurs when melanin is overproduced in certain spots on the
skin. Hyperpigmentation results in flat, darkened patches of skin that are light
brown to black in colour, and can vary in size and shape.
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Hyperpigmentation treatment strategy in cosmetic field
By Dr. Mohammad Baghaei
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Hyperpigmentation in endocrine disorders
Generalised increased skin pigmentation is most intense on light exposed areas, in
flexures, at sites of friction and pressure, in the creases of the palms and soles,
and on all mucous membranes. The pattern is not specific and the possibility of
Addison’s disease should be considered in any case of increased pigmentation. In
autoimmune Addisons disease, patches of nonpigmented skin ie vitiligo may also be
present.
1. adrenal failure
2. acromegaly
3. Cushing’s syndrome
4. hyperthyroidism
5. phaeochromocytoma
6. carcinoid syndrome
7. high dose ACTH therapy
By Dr. Mohammad Baghaei
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Pigmentation associated with nutritional deficiencies
1. deficiencies of any of vitamins A, C, niacin, folate or B12
2. malabsorption syndromes
3. "Vagabonds" disease? post-inflammatory pigmentation
Pigmentation associated with drugs
1. anti malarials
2. arsenic
3. chlorpomazine and related phenothiazines
4. phenytoin (appears like chloasma)
By Dr. Mohammad Baghaei
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Hyperpigmentation in malignant disease
1. diffuse pigmentation in cachexia
2. diffuse slaty-blue colour due to melanoma
3. acanthosis nigricans (localised to the flexures). mild cases are frequently
seen in subjects with insulin resistance eg polycystic ovary syndrome,
acromegaly and unexplained cases.
By Dr. Mohammad Baghaei
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By Dr. Mohammad Baghaei
Hyperpigmentation treatment strategy in cosmetic field
There are three main types of hyperpigmentation, each of
which is categorized by their cause.
Post-inflammatory hyperpigmentation (PIH):
This occurs following skin injury from acne lesions, psoriasis, burns, friction and
even certain professional skin care treatments. It begins to fade as the skin
regenerates itself—a process that can take months or more. On the positive side,
PIH generally responds well to treatment.
Lentigines, Age Spot:
These are commonly known as age spots. Although they do become more
prevalent with age—they are found on 90% of light-skinned individuals over the age
of 60—they are not directly caused by the aging process. Rather, lentigines are
related to UV exposure. they appear mainly on body parts that are frequently
exposed, such as the face, hands and arms. They tend to be small, darkened
patches of skin
Melasma:
Melasma or chloasma , is often referred to as “the mask of pregnancy”, as it
affects 90% of pregnant women. It occurs as a result of hormonal influences such
as pregnancy and birth control pills, and causes dark and irregularly shaped areas
on the face or arms that can be quite large.It affects an estimated five to six
million women in the United States alone and can often be difficult to treat.
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Things that can cause post-inflammatory pigmentation:
cystic acne or healing pimple
cosmetic procedures – lasers, IPL, microdermabrasion
deep chemical peels
chemical exfoliants – AHA’s and other acids
overuse of certain ingredients (e.g. Benzoyl Peroxide)
mechanical trauma – a wound that leads to a scar or discoloration
anything that causes excessive irritation
Hyperpigmentation treatment strategy in cosmetic field
By Dr. Mohammad Baghaei
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Hyperpigmentation treatment strategy in cosmetic field
Hyperpigmentation treatment strategy (due to melanin), various ways:
1. Inhibit melanin production or deposits to prevent pigmentation from forming in the first place. Brightening ingredients work by blocking different steps of the melanin production pathway.
2. Remove melanin deposits by chemical means – exfoliating with AHA’s, getting chemical peels By increasing of cell turnover, which help move the melanin out of skin faster, using retinoids like Tretinoin or Retinol, brightening ingredients like Vitamin C, or a lightening agent like Hydroquinone.
3. Remove melanin deposits by mechanical means – ablative lasers which remove layers of skin, IPL (intense pulsed light) which shatters melanin pigment granules. Lasers are the best method for removing dermal pigment because they can penetrate all the way into the dermis. (Only By Dermatologist)
4. Slow down melanin production with injections (key ingredient is glutathione). (Only By Dermatologist)
By Dr. Mohammad Baghaei
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Legal Lightening Agent (in the U.S.):
Hydroquinone (less than 2% for non-prescription, more than 2% must be acquired
by prescription in the U.S.)
Similar to Hydroquinone:
Kojic Acid (similar in structure to Hydroquinone, found in some mushrooms)
Arbutin (glycosylated form of Hydroquinone, gentler, found in Bearberry, Paper
Mulberry, Blueberry, Cranberry)
Mequinol (ether of Hydroquinone, used with Tretinoin, by Rx only)
By Dr. Mohammad Baghaei
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Some of Other Plant-Derived Brighteners:
Licorice Root (botanical Latin name: Glycyrrhiza Glabra, may see this as Glycyrrhizate on an
ingredient list)
Glabridin (main oil-soluble compound found in licorice root)
Pine Bark (botanical Latin name: Pinus Pinaster)
Pycnogenol (main compound found in pine bark)
Indian Gooseberry (botanical Latin name: Phyllanthus emblica)
Willow Herb (botanical Latin name: Epilobium angustifolium, one of the sources of Salicylic Acid)
Cucumber
By Dr. Mohammad Baghaei
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Some of Exfoliating Ingredients:
Azelaic Acid
Lactic Acid
Phytic Acid
Glycolic Acid
Salicylic Acid
Trichloroacetic (TCA)
Enzymes (e.g. papain, bromelain)
By Dr. Mohammad Baghaei
Hyperpigmentation treatment strategy in cosmetic field
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Some of Other Chemicals:
Retinoids (e.g. Retinol, Tretinoin)
Vitamin C
Niacinamide
Glucosamine
Soy (fractionated, without the estrogenic fractions, estrogen worsens melasma)
Resorcinol
By Dr. Mohammad Baghaei
Hyperpigmentation treatment strategy in cosmetic field
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Which Ingredients Are Effective? • There are no definitive answers on which
ingredients are most effective. But one thing is clear. To treat hyperpigmentation effectively, a blend of brightening ingredients are needed.
• The pigmentation process is a long sequence of steps. Brightening ingredients work by blocking different steps. The more steps that are blocked, the better. And the earlier the steps are blocked, the better.
By Dr. Mohammad Baghaei
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Hydroquinone – most effective for lightening but controversial .
Kojic Acid – effective but controversial, has anti-bacterial properties
Licorice – strong tyrosinase inhibitor, 25x better than Kojic Acid, also anti-
inflammatory and antioxidant
Paper Mulberry – not a strong tyrosinase inhibitor compared with other
ingredients but has low risk for irritation and is anti-inflammatory
Azelaic acid – inhibits the growth of melanocytes (the cells that produce
pigment), a tyrosinase inhibitor, mild exfoliant, anti-bacterial
Lactic acid – a tyrosinase inhibitor, also hydrating, exfoliating, and anti-bacterial
AHA’s & Enzymes – only exfoliate skin, increasing cell turnover and ‘washing’
melanin out of skin faster, but do not target root cause of pigmentation
Vitamin C (L-Ascorbic acid) – good for providing overall radiance and brightening
Phytic Acid – works by blocking oxidation in the melanogenesis process
Retinoids – suppress melanosome transfer during the pigmentation process,
increases cell turnover and exfoliates skin so that melanin is removed from skin
faster
Hyperpigmentation treatment strategy in cosmetic field
By Dr. Mohammad Baghaei
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