Are products that reduce pigmentation of the skin safe for long term use?

One of the key reasons we started ESK. To make skincare minus the “nasties”. 

So you’ve got pigmentation… you want to tackle it but you’re worried about safety and tolerability of the ingredients you might be putting on your skin. Given that patience is required when managing pigmentation, it is especially important to use products that are safe. 

There are safety concerns about many of the ingredients in skincare we commonly see in popular skincare brands. Nowhere is that truer than with depigmenting ingredients, such as Hydroquinone which is banned in many jurisdictions around the world due to safety concerns.  

Renee M Before and After

By Daniel, ESK Co-Founder

We helped Renee with her Pigmentation using ESK’s Pigmentation Kit, this article is about what can help you too. 

We wanted ESK’s depigmentation products to be: 

 1) Safe and with no safety concerns anywhere in the world

 2) Non- irritating as it needs to be used regularly 

 3) Good evidence of effectiveness

There really was no solution that ticked all three boxes until evidence emerged for 4-n-butylresorcinol (the key active ingredient in our Enlighten). 

And so we developed Enlighten, using this amazing ingredient for pigmentation. While it’s key active ingredient has good evidence, is well tolerated and has a good safety profile, perhaps due to cost, difficulty in sourcing and formulating, it is very (very) rarely used in skincare products

 

Depigmentation agents: What’s available and their potential side effects to consider 

So let’s go through the depigmenting ingredients you will see in prescription and non-prescription skincare and their potential harms; 

  1. 4-n-butylresorcinol (non- prescription): We have studies that have gone on for several weeks and months and found high effectiveness. And while long term data is lacking, studies have seen limited if any short term irritation and have not raised any long term safety concerns. Right now, that makes 4-n-butylresorcinol the only Evidence based ingredient in this class without irritation or safety concerns….Which is why we use it in our Enlighten {insert link to product}
  2. Hydroquinone (under Prescription at effective strengths): Usually referred to as the gold standard in managing hyperpigmentation. There are a couple of issues around hydroquinone. Some people experience short term itching, burning, and redness. That is one reason it is often prescribed with a hydrocortisone cream. One potential issue, albeit rare is ochronosis. That’s blue-black or gray skin discoloration. It tends to be more common in people who use it at a high concentration for a long period of time. There are also concerns about its potential link to cancer– which have never been proven. But these concerns have led Regulatory agencies in Japan, Europe, and the US to raise concerns. And increasingly it has led to the search for a replacement.
  3. Steroid creams: Long term steroid use, especially on the face, has well documented side effects. These include thinning of the skin, proneness to stretch marks, worsening rosacea, perioral dermatitis (redness, dryness, and pimples in a cluster around the mouth and chin), worsening acne and purple blotches. Less common side effects of long term steroid use on the face include Hypertrichosis (excess hair growth), poor wound healing and white patches due to excessive pigment loss. These side effects tend to settle down when you stop using the steroid creams.
  4. Kojic and Azelaic acid (under Prescription at effective strengths) and to a lesser extent Arbutin: Stinging and irritation are common but long term data are lacking. 

 

We created the Kit for Pigmentation to include ingredients from each of the above groups which not only have some of the best evidence but are also safe and gentle. To our mind that makes our pigmentation kit unique 

 

What to do about Pigmentation: 

A recommended pigmentation management regime should include the following components:

  1. Sun protection: Both UVB but critically, a high level of UVA protection (by the way, there are few ingredients commonly used in sunscreens that have safety clouds. But that can use every day to prevent pigmentation. 
  2. Antioxidants: Vitamin A, B3, and C have good evidence and are largely considered safe. You can find Vitamin A in our Ultimate A, which has Retinal which is the most effective and least irritating form of Vitamin A to increase skin turnover. Vitamin C is the key ingredient in our Reverse C Serum, to tackle pigmentation and sun damage. Vitamin B is in our Hero-Product for Pigmentation – our Enlighten (see below for its key unique ingredient)
  3. Exfoliators: Glycolic and Salicylic acid have good evidence but can increase sun sensitivity, so make sure you wear sunscreen if exfoliating. And while low doses are well tolerated, high concentration peels, often used for depigmentation involve irritation and can’t be repeated too many times. Our Smooth Serum is gentle and can be used daily.is a topic for another time). ESK’s Zinc Shade is a broad-spectrum sunscreen, that you 
  4. Depigmentation agents: Group of ingredients which are considered the most effective (if slow to act) but where the safety concerns exist and where increasingly people are looking for alternatives which are effective, safe and well-tolerated alternatives.

 

If you have any doubts about which depigmenting agents will work best for your pigmented skin, ask a doctor. You can also check out our Kit for Pigmentation

 

Other articles you might be interested in:

 

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883392/

https://www.sciencedirect.com/science/article/pii/S1027811714000445

https://www.sciencedirect.com/topics/medicine-and-dentistry/hydroquinone

https://www.ncbi.nlm.nih.gov/books/NBK539693/

https://www.dermnetnz.org/topics/hydroquinone/

https://journals.lww.com/jbisrir/Fulltext/2016/12000/Long_term_topical_corticosteroid_use_and_risk_of.13.aspx

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4228634/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171912/

https://www.sciencedirect.com/science/article/pii/S2352647518300431

 

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