Hello Breeze50,
There are certainly a lot of skin whitening products on the market
? even more than I imagined! I certainly understand your frustration.
Even with all the products manufactured, they all still use several
basic ingredients, all of which work to a degree. As you?ll read
further down, some have side effects, and some work better for some
skin types that others. Your best source of information however, would
be a dermatologist, who can examine your skin and help you select the
best product for you. I?ve collected quite a few sites that explain
the different products; pros and cons. Please check each link for
complete information. You'll notice that I gathered my information,
primarily from sites that do NOT sell products!
?When it comes to selecting treatment for these areas, one factor to
consider is the depth of the discolored pigment. Most of the time
discoloration is superficial. In a few cases, the discoloration lies
deep in the dermis. If the pigment is in the epidermis, it can be
helped with skin-lightening products. If the pigment is deeper, laser
treatments are a consideration. For topical treatments, according to
an article in The American Journal of Clinical Dermatology
(September-October 2000, pages 261?268), "[T]opical hydroquinone 2 to
4% alone or in combination with tretinoin 0.05 to 0.1% is an
established treatment. Topical azelaic acid 15 to 20% can be as
efficacious as hydroquinone?. Tretinoin is especially useful in
treating hyperpigmentation of photoaged skin. Kojic acid, alone or in
combination with glycolic acid or hydroquinone, has shown good
results, due to its inhibitory action on tyrosinase. Chemical peels
are [also] useful to treat melasma."
http://www.cosmeticscop.com/learn/article.asp?PAGETYPE=ART&REFER=SKIN&ID=25
?Among skin-lightening agents, hydroquinone (HQ) is one of the most
widely prescribed agents in the world. However, with reports of
potential mutagenicity and epidemics of ochronosis in African nations,
there has been increasing impetus to find alternative herbal and
pharmaceutical depigmenting agents. A review of the literature reveals
that numerous other depigmenting or skin-lightening agents are in use
or in investigational stages. Some of these, such as kojic and azelaic
acid, are well known to most dermatologists. Others more recently have
been discovered and reported in the literature.?
?The 2% HQ is readily available over-the-counter in various cosmetic
preparations. However, for better efficacy, it often is compounded
into various mixtures for treatment of hyperpigmentation. The original
Kligman formula involves compounding 5% HQ with 0.1% retinoic acid and
0.1% dexamethasone in a hydrophilic ointment base. Concentrations as
high as 10% can be compounded extemporaneously for refractory cases.
Evidence of improvement with HQ (monotherapy) usually is observed at
4-6 weeks, with improvement appearing to plateau at about 4 months.
Despite its remarkable overall safety, the physician ought to bear in
mind the potential adverse effects. Contact dermatitis occurs in a
small number of patients and responds promptly to topical steroids. An
uncommon, yet important, adverse effect of HQ is exogenous ochronosis.
This disorder is characterized by progressive darkening of the area to
which the cream containing HQ is applied. Histologically, degeneration
of collagen and elastic fibers occurs. This degeneration is followed
by the appearance of characteristic ochronotic deposits consisting of
crescent-shaped, ochre-colored fibers in the dermis.?
http://www.emedicine.com/derm/topic528.htm
?Skin-whitening products work in various ways. Some contain acids
that remove old skin to reveal newer, lighter skin underneath. Others
inhibit melanin, like those with mulberry extract, licorice extract,
kojic acid, arbutin and hydroquinone, an ingredient in prescription
creams for blemishes as well as in photo processing materials.
Some of the most effective agents are also risky ? and are often the
least expensive, like mercury-based ingredients or hydroquinone, which
in Thailand sells for about $20 per kilogram (2.2 pounds), compared
with highly concentrated licorice extract, which sells for about
$20,000 per kilogram.
Hydroquinone has been shown to cause leukemia in mice and other
animals. The European Union banned it from cosmetics in 2001, but it
shows up in bootleg creams in the developing world. It is sold in the
United States as an over-the-counter drug, but with a concentration of
hydroquinone not exceeding 2 percent.?
http://www.nytimes.com/2006/05/14/world/asia/14thailand.html?ex=1305259200&en=58475681dbd045a9&ei=5088&partner=rssnyt&emc=rss
Mainly the Skin Whitening Ingredients works in two ways to give you
a whiter skin:
1. By absorbing the UV rays, thus preventing the sun from darkening your skin.
2. By reducing the production of melanin, the skin pigment found in
your skin which is responsible for skin darkening.
Here are some of the ingredients you may find in your skin whitening products:
Kojic Acid:
It is used to lighten the skin in Japan. It is a tyrosinase inhibitor.
That would explain how it reduces the production of skin pigment,
melanin.
Licorice Extract:
This absorbs the UVA and UVB rays. It also is a depigmenting agent and
inhibits the production of melanin.
Aloe Vera:
Aloe Vera appears to absorb UV light. That would account for its mild
skin lightening abilities.
Octyl-p-methoxycinnamate:
This is a sunscreen. It absorbs UV light very well, preventing the UV
rays from darkening your skin.
Octyl salicylate:
This is a salt of the saliculic acid that is found in wintergreen
leaves. It is a sunscreen, found in sun tan lotions.
Oxybenzone:
This is a sunscreen chemical that absorbs UVA rays.
http://www.ultimate-cosmetics.com/skin-whitening.htm
?By the National Poison Centre
Q: Hydroquinone creams were highlighted recently as adversely
affecting the skin. Can you explain the use of these products and
their effects?
A: The recent statement by the Minister of Health against beauticians
prescribing skin bleaching products containing more than two per cent
hydroquinone follows the world-wide concerns about the use of such
products (NST, Feb 2).
The move to create awareness about the adverse effects caused by these
products was needed considering that the demand for them has increased
so much that they are now illegally manufactured here to meet demand.
Although they serve a cosmetic function in lightening skin colour, it
must be known that these products are drugs and have potential
toxicity if used without advice from doctors.
Originally, a number of topical agents have been used in
skin-bleaching preparations. These included hydroquinone, the
monobenzyl and monomethyl esters of hydroquinone, ammoniated mercury,
ascorbic acid and peroxides.
Unfortunately, most of these agents have limited clinical use because
of their effects and resultant complications. For example, mercury
compounds have been used with varying success to lighten skin pigment.
The mercury ions are thought to inhibit the synthesis of melanin, a
black pigment responsible for darkening the skin.?
?Darker lesions repigment faster than lighter lesions. Because the
ability of the sun to darken lesions is greater than that of
hydroquinone to lighten them, strict avoidance of sunlight is
important.
The effectiveness of hydroquinone varies among patients. In a US
study, hydroquinone two per cent and five per cent creams were applied
on the hyperpigmented skin of 56 patients with 12 per cent of the
patients being black.
Hydroquinone cream was applied twice daily and the treatment was
continued for three months. Hydroquinone was effective as a
depigmenting agent in 44 of the cases. The use of hydroquinone five
per cent cream was accompanied by adverse effects, mainly irritation.
However, at the lower concentration (two per cent cream), the drug
appeared to be equally effective therapeutically with fewer irritant
reactions. From the result, it seems that hydroquinone is best on
lighter skin and on lighter lesions.?
http://www.prn2.usm.my/mainsite/bulletin/nst/1998/nst12.html
?Depigmentation is a treatment in which a person may choose to remove
the pigmentation from the unaffected skin areas to better match the
affected areas. This is used in cases where vitiligo is extensive. The
person uses a cream containing monobenzyl ether of hydroquinone to
remove remaining pigment. This process takes a long time to complete,
sometimes a year or more. Removal of pigment is permanent?
http://www.mediresource.com/sdm/sdm/english/disease_detail.asp?disease_id=302
Hydroquinone is a common skin bleach, intended to fade age spots and
small skin discolorations.
Some products that contain hydroquinone Eldopaque, Eldopaque Forte,
Eldoquin-Forte Sunbleaching, Esoterica Facial, Esoterica Regular,
Esoterica Sunscreen, Melquin HP, NeoStrata AHA Gel for Age Spots and
Skin Lightening, Nuquin HP, Solaquin, Solarquin Forte
?What drug(s) may interact with hydroquinone? (Back to top)
?benzoyl peroxide
Check with your prescriber if you are using other medications which
are applied to the skin.
Non-medicated cosmetics, sunscreens, and moisturizing lotions may be
worn over the hydroquinone preparation. However, wait several minutes
after application of hydroquinone before applying them.?
Please read the entire site for further information.
http://www.drugdigest.org/DD/DVH/Uses/0,3915,6150%7CNeoStrata+AHA+Gel+for+Age+Spots+and+Skin+Lightening,00.html
?Over-the-counter skin-lightening products often contain 2%
hydroquinone, while 4% concentrations are available only from a
physician. Hydroquinone is a strong inhibitor of melanin production
(source: Journal of Dermatological Science, August, 2001, Supplemental
pages S68?S75), meaning that it lightens skin color. Hydroquinone does
not bleach the skin (calling it a bleaching agent is a misnomer); it
only disrupts the synthesis of melanin hyperpigmentation.
In the medical literature Hydroquinone is considered the primary
topical ingredient for inhibiting melanin production. Using it in
combination with the other options listed can make a difference in
skin discolorations (Sources: Journal of Cosmetic Science, May-June
1998, pages 208?290; Dermatological Surgery, May 1996, pages 443?447).
Some concerns about hydroquinone's safety on skin have been expressed,
but the research indicates reactions are minor or a result of using
extremely high concentrations (Source: Critical Reviews in Toxicology,
May 1999, pages 283?330).?
?Hydroquinone can be an unstable ingredient in cosmetic formulations.
When exposed to air or sunlight it can turn a strange shade of brown.
It is essential, when you are considering a hydroquinone product, to
make sure it is packaged in a non-transparent container that doesn't
let light in and minimizes air exposure. Hydroquinone products
packaged in jars are not recommended, because they become ineffective
shortly after opening.?
http://www.cosmeticscop.com/learn/article.asp?PAGETYPE=ART&REFER=SKIN&ID=25
Tretinoin
---------
?Results can also take far longer with tretinoin than with other
treatments, requiring at least six months or so before improvement is
seen. Because of this, tretinoin is generally not recommended as the
only option for skin discoloration but it can be used in combination
with other effective topicals (source: eMedicine Journal,
www.emedicine.com, November 15, 2001, Volume 2, Number 11). Even
though tretinoin can be disappointing for skin lightening, that should
in no way diminish the role it plays in the improvement in skin's cell
production, collagen production, elasticity, texture, and dermal
thickness. Tretinoin, combined with more effective skin-lightening
treatments, is a powerful alliance in the battle against sun-damaged
and aged skin.?
http://www.cosmeticscop.com/learn/article.asp?PAGETYPE=ART&REFER=SKIN&ID=25
Alpha Hydroxy Acids
--------------------
?In and of themselves, alpha hydroxy acid products in concentrations
of 4% to 10% are not effective for inhibiting melanin production and
won't lighten skin discolorations. However, there is evidence that in
combination with other treatments such as kojic acid, hydroquinone,
azelaic acid, and laser resurfacing they can be very effective for
improving the overall appearance of sun-damaged skin and possibly
helping the other ingredients penetrate the skin better.
Much like laser treatments, alpha hydroxy acid peels (using 50%
concentrations) have impressive results for removing skin
discolorations (Source: Dermatological Surgery, June 1999, pages
450?454). Only a physician should perform these types of facial
peels.?
http://www.cosmeticscop.com/learn/article.asp?PAGETYPE=ART&REFER=SKIN&ID=25
Kojic Acid
----------
?Kojic acid is a by-product in the fermentation process of malting
rice for use in the manufacturing of sake, the Japanese rice wine.
There is convincing research, both in vitro (in a test tube) and in
vivo (on a live subject), showing kojic acid to be effective for
inhibiting melanin production (Source: Archives of Pharmacal Research,
August 2001, pages 307?311). Glycolic or kojic acid, or glycolic acid
with hydroquinone, are highly effective in reducing the pigment in
melasma patients?
http://www.cosmeticscop.com/learn/article.asp?PAGETYPE=ART&REFER=SKIN&ID=25
?Magnesium ascorbyl phosphate
-----------------------------
Magnesium-L-ascorbyl-2-phosphate (MAP) is a stable derivative of
ascorbic acid. When used as a 10% cream, MAP was shown to suppress
melanin formation. A significant lightening effect was seen clinically
in 19 of 34 patients with melasma and solar lentigos. Furthermore, MAP
has been shown to have a protective effect against skin damage induced
by UV-B irradiation. The latter protective effect is because of the
conversion of MAP to AS.?
http://www.emedicine.com/derm/topic528.htm
?Dermatologists claim that there is no such thing as a fairness cream,
certainly not without using skin-bleaching agents such as
hydroquinone, steroids, mercury salts, and a number of other
ingredients including bismuth subnitrate, hydrogen peroxide, magnesium
peroxide and zinc peroxide.?
All of these ingredients, says Prof ABM Faroque, Chair, Department of
Pharmaceutical Technology, University of Dhaka, can cause, among more
serious health hazards, nephrotoxicity, mercury toxicity and serious
allergic reactions. Nephrotoxicity refers to irritation to nephrons in
the kidney, causing kidney damage. Mercury toxicity includes effects
like metallic taste, increased thirst, abdominal pain, bloody
diarrhoea, nephritis, decreased flow of urine, colitis or
constipation, tremors, anaemia, and skin problems. Mercury has adverse
effects on the developing brain of a foetus.
Fairness cream market leader in Bangladesh, Fair and Lovely, however,
claims that it does not use any skin-bleaching agents and neither does
its formulation include any harmful ingredients like hydroquinone,
steroids or mercury.
According to scientists at Unilever, Fair and Lovely "lightens skin
safely and reversibly through a synergistic and patented combination
of" Vitamin B3 (niacinamide) and a mixture of US FDA- and EU-approved
UV-A and UV-B sunscreens. Ayurvedic Fair and Lovely also contains
natural skin-lightening agents such as Kumkumadi Tailum.
Unilever claims that niacinamide topically applied is effective in
reducing hyperpigmentation and lightening skin colour and that it is
also beneficial in terms of anti-ageing, overall skin texture, etc.
http://www.thedailystar.net/magazine/2006/05/02/cover.htm
?Dermal pigmentation disorders, such as melasma, arise from
increased melanin in the epidermis and increased free melanin and
melanophages. The pigmentation occurs deeper in the skin, and has a
less distinct border. The pigmentation is brown, but the color may be
mixed with gray or blue. In general, dermal pigmentation disorders are
difficult to treat.
"Bleaching creams are the most frequently used therapies, but the
efficacy is less than ideal," Dr. Zhou says. "Better therapies are
needed."
http://mediwire.skyscape.com/main/Default.aspx?P=Content&ArticleID=188726
?Even a little bit of sun worshipping can cause age spots later in
life. Sunlight contains ultraviolet rays that cause suntans and burns.
As time goes by, tanning causes more pigment than normal to be
deposited in the skin. This leads eventually to flat, brown skin
lesions known as age spots. They're also known as liver spots or sun
spots.
Symptom Relief
Age spots are harmless. They're benign and they do not go on to become
any type of skin cancer or premalignant skin lesion," Dr. Clark says.
But because some skin cancers such as melanoma can look like age
spots, you should ask your doctor to examine your skin during your
annual checkup.
Here are a couple of ways to deal with these telltale signs of
excessive sun exposure.
Bleach it out. If your age spots aren't too dark or large,
over-the-counter skin-bleaching creams containing hydroquinone could
help them fade away, says Marc Bauder, M.D., a family practice
physician in Sun City West, Arizona. Be sure to follow the
manufacturer's directions carefully when applying the cream to your
skin.
Don't overexpose yourself. The best way to treat and prevent age spots
is to cut the time you spend in the sun. Once you have these spots,
sunlight can make them appear darker and more prominent, Dr. Bauder
says. To prevent that, always wear a sun block that has a sun
protection factor (SPF) of at least 15 on exposed skin. In addition,
try to wear a long-sleeved shirt and a broad-brimmed hat whenever
you're outdoors.?
Ask about a peel. When someone has dozens of age spots, doctors
suggest a trichloroacetic acid chemical peel (TCA), says Dr. Clark.
The peel, which is applied in a doctor's office, removes the top layer
of skin where the spot is located.?
http://www.mothernature.com/Library/Bookshelf/Books/16/3.cfm
?To help keep hands looking young, use a specially formulated hand
cream with sun block at least once a day. To treat age or ?liver?
spots, dermatologists can use Retin A to help lighten small spots over
time. Hydroquinone, a bleaching cream, often is used to lighten the
spots, but some European scientists have questioned the drug?s safety
in recent years. Liquid nitrogen, laser treatment, and chemical peels
are some other options.
The best way to avoid age spots is to stay out of the sun. ?Sun
exposure is one of the most common environmental sources for aging the
skin,? Ali says. ?It increases the risk for skin cancer and
photo-aging.?
http://www.uthouston.edu/hleader/archive/Dermatology/2005/agingskin-1018.html
?...about half of all Thai dermatologists prescribed creams with
hydroquinone. He stopped prescribing it a decade ago when he noticed
patients with redness and itching and with more serious side effects
like ochronosis, the appearance of very dark patches of skin that are
difficult to remove.
Some patients also develop leukoderma, where the skin loses the
ability to produce pigment, resulting in patches of pink like those on
Ms. Panya's face and neck.
When she first began using the cream, which was packaged under the
name 3 Days and cost the equivalent of $1, she said she was very happy
with the results.
Her skin started itching, but she tolerated it because her complexion
lightened considerably. She got bigger tips at the restaurant, where
she sang folk songs, she said.
But when her face became blotchy two months later, her boss told her
she could no longer sing at the restaurant because she was unsightly.?
http://www.nytimes.com/2006/05/14/world/asia/14thailand.html?pagewanted=2&ei=5088&en=58475681dbd045a9&ex=1305259200&partner=rssnyt&emc=rss
?In clinics in Arizona, for example, doctors had observed more than
300 patients who had toxic levels of mercury in their urine. I found
medical reports of similarly high levels of mercury poisoning among
patients in Saudi Arabia, Senegal, West Africa, and in Tanzania in
East Africa. Even among newly arrived Bosnian and Albanian refugees in
Germany, doctors have found patients with toxic levels of this same
type of mercury.
One of my first clues to unraveling this mystery turned out to be
basic geography: Most of the reported mercury-poisoning cases were
found in nations in the lower latitudes.
The second clue: In Mexico, as in other countries such as Saudi Arabia
and Pakistan, most of the patients with clinical evidence of mercury
poisoning were women. Even in the Southwestern Unites States, 96
percent of the more than 300 patients found to have abnormal mercury
levels were female.
In every case, clinical questioning revealed that the women had used
skin-whitening creams -- many for years. In other words, these women
had tried so desperately to whiten their skin color that they had
poisoned their bodies by applying mercury-based "beauty creams."
http://www.boston.com/news/globe/health_science/articles/2003/12/16/whitening_skin_can_be_deadly/
Interesting research
http://www.scienceboard.net/community/memberSpotlight.asp?spotid=15
?If you have age spots, you're at a higher risk of developing skin
cancer, so it is important to see your doctor if they change colour or
appearance or if you are worried about them. Once your doctor gives
you a clean bill of health, discuss the various options for minimising
the appearance of age spots.
There are several over-the-counter and prescription treatments for age
spots, available at your local chemist. Remember, though, that with
whichever method you choose, results will vary depending on how severe
the spots are, how much time you spend in the sun and how consistently
you follow treatment. It's essential to protect your skin against new
age spots and prolong the result of treatment by wearing sunscreen on
all exposed areas of the body every day, even in winter.?
http://www.ivillage.co.uk/beauty/skincare/aging/qas/0,,547681_183592,00.html
There you go! It appears that retinoids and hydroquinone's may be
the most effective type of cream, but each ahs it?s own drawbacks, as
you have read. Remember that in order to work, the creams must be
applied as the label states, and used regularly, over several months
before seeing results.
Remember too that staying out of the sun as much as possible is
necessary to prevent further skin damage. When in the sun, use a good
sunscreen and a hat!
I would suggest discussing this with your dermatologist. From my
research, I found that different products work differently for each
person. It could take years before you found the product that works
best for your skin. Your doctor can also rule out any skin conditions
and perhaps suggest a prescription strength lightener.
If any part of my answer is unclear, please request an Answer
Clarification, and allow me to respond, before rating. I?ll be glad to
help you further on this question, before you rate.
Sincerely, Crabcakes
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