Looking for a luminous complexion? Dr Zara Kassam takes a look at skin brighteners – what they do and how they work.

We’re all after a complexion that looks like we’ve never touched junk food, stayed up too late or baked ourselves under the sun, and that’s where skin brighteners come in.

Some products use light reflecting molecules to help give skin a healthy glow, but they only mask problems. When it comes to skin brightening, fading or reducing pigment spots there’s a whole lot of science that goes into the products that can actually make a difference.

If products contain the right ingredients they can help undo UV damage, fade acne scars, and lighten and brighten a dull complexion.

What causes pigmentation spots?

First up, lets look at what causes pitmentation spots. The most common causes are:

1. Post-inflammatory hyperpigmentation – darkening caused by some sort of irritation or injury, such as acne. It’s a result of the cells releasing pigment and staining the skin.
2. Sun damage, which results in sun spots and freckles. Dark spots can also be caused by air pollution.
3. Hormones – they can increase the product of melanin, leading to increased pigment in the skin. The most common example is Melamsa, which can affect pregnant women.

What are brightening products?

The term ‘brightening’ in the cosmeceutical world is used loosely. Brightening may refer to:

• Lightening
• Fading
• Bleaching

Brightening products contain ingredients that act to block the production of pigment, or help increase cell turnover so that the darker-stained uppermost layers of the skin can exfoliate away, revealing lighter healthier skin. Others act as bleaching agents to help fade them away.

It’s important to note that there is a wide range of topical de-pigmenting treatments available and the results can be variable along with their safety. Some are only available on prescription. (2)

What are the most common skin brightening ingredients?

The key ingredients for reversing UV damage and in turn brightening your skin are antioxidants or acid. Some are available in both prescription strength or in milder concentrations in over-the-counter products.

Some of the most common ingredients include:

• Azelaic acid
• Glycolic acid
• Glucosamine
• Hydroquinone
• Kojic acid
• Vitamin C
• Retinoids (vitamin A)

Hydroquinone was the most commonly prescribed hyperpigmentation treatment before the long-term safety concerns were raised and the use of it was regulated in several countries and discouraged in general by World Health Organization. In many countries including the UK 2% is at present sold over-the-counter, and 4% needs prescription.

Hydroquinone acts by bleaching the skin but should be used with caution; It may be an effective ingredient but it has been banned in many countries due to the of the risk of ochrinosis, a rare but usually irreversible blue or black hyperpigmentation of the skin.

People with darker complexions should be especially cautious when using it.

Hydroquinone is sometimes combined with natural skin lighteners like Kojic Acid, Azelaic Acid and Vitamin C for extra potency. It may also be combined with alpha hydroxy acids (AHAs) like Lactic Acid and beta hydroxy acids (BHAs) like Salicylic Acid which act as exfoliants. They encourage cell renewal.

All of the skin lightening ingredients and the combination of AHAs and BHAs make many brightening products very effective – but make sure to nourish your skin with moisturising creams and protect it with sunscreen while using such products.

Azelaic acid

Azelaic acid is usually used to treat mild to moderate acne. But it has been used for treatment of skin pigmentation including melasma and post-inflammatory hyperpigmentation, particularly in those with darker skin types. It has been recommended as an alternative to hydroquinone.

This acid inhibits the enzyme tyrosinase, which is responsible for producing melanin, and over time pigmentation will fade and your skin will appear more radiant and healthy-looking.[4] Kojic acid is also frequently used and has gained popularity because of its safety profile, this acid is known to help lighten sunspots and fade post-inflammatory stains without the risk of bleaching.

Retinoids

Retinoids (Vitamin A) are also another common treatment prescribed for acne, photodamage and post inflammatory hyperpigmentation.  The most common oral medications are tretinoin, adapalene and Isotretinoin. These are prescription only medication (POM) and like Azelaic acid, work by inhibiting the enzyme tyrosinase so your skin will appear more luminous.

Many over-the-counter products contain weaker versions of vitamin A which have been shown to be effective if in a concentration of at least 1%.

Antioxidants

Nicotinamide – can be very beneficial to those with dark spots or hyperpigmentation. Also known as Vitamin B3, this dynamic ingredient will provide hydration to the skin to keep it moisturised; as well as this It will also plump up the skin to make it tauter and firmer which will smooth away any wrinkles. It is also known to benefit acne and is used in products that will lighten the skin for treatment of hyperpigmentation by slowing down the melanin production.

Studies have successfully shown that with the application of 2% nicotinamide over 4 weeks is effective in lowering the sebum excretion, which in turn will leave you skin looking and feeling better.

Glycolic acid

Glycolic acid is an alpha-hydroxy acid derived from sugar cane and is also used for its skin lightening effects. At low concentrations, glycolic acid  encourage rapid desquamation or exfoliation of pigmented skin cells. Like retinoids, glycolic acid shortens the skin cell cycle so that pigment is lost more rapidly.

Studies have shown that the removal of superficial layers of epidermis with glycolic acid peels at concentrations of 30%–70% can improve the penetration of other topical skin lighteners such as hydroquinone.

Tip: To make the most of skin brighteners make sure your skin is well exfoliated.

Alternative products:

There are many alternative skin-lightening products containing ‘natural’ ingredients that are available online and in shops without prescription. These are legal and unlikely to be harmful, but there’s no guarantee they will work.

Prevention is better than cure

Sunscreen every day is a must. No matter how good their ingredients are, skin brighteners will not work if they are not combined with a broad-spectrum sunscreen. And once brown spots or uneven colouring are gone, people must continue to use broad-spectrum sunscreens, or they will just reappear.

Getting rid of pigment spots is not easy and it won’t happen overnight – it will take many weeks. And if over-the-counter products aren’t giving you the result you’re after, speak to your dermatologist who may suggest other treatments.