Friday, 20 November 2015 04:21

Hyperpigmentation: Prevention, Maintenance, Reversal

Written by   Dieter Kuster, Ph.D.

As one of the most common skin conditions, hyperpigmentation affects millions of people and has a variety of causes and symptoms. While many hyperpigmentation disorders are harmless, some can be cause for concern. It is important to understand the different symptoms and treatments available in order to make the most informed decisions regarding the client’s skin health. Many hyperpigmentation disorders can be avoided when proper preventative measures are taken, but for those clients that live with skin conditions ranging from darkened patches to scaly lesions, the need for a safe, effective treatment is of the utmost importance. While all of the problems of hyperpigmentation have not been solved, cosmetic scientists are taking steps to formulate a product that will deliver serious effectiveness, not serious side effects.

To understand the causes of hyperpigmentation, it is important to first comprehend what it is and how it relates to the different causes of aging. Hyperpigmentation is the increase of melanin in an area of the skin that occurs due to ultraviolet damage, inflammation, or other skin injuries. Increased melanin creates darkened patches of skin that can prove very distressing for the afflicted client. Intrinsic aging refers to chronological aging and personal stressors such as health, family, business, and finances. Extrinsic aging takes place due to external factors, such as sun and wind exposure, environmental pollutants, tobacco use, drug and alcohol abuse, and geographic location. While some of these cannot be avoided or controlled, preventative measures should be incorporated into the client’s daily lifestyle to protect against the external factors that can be regulated. In regards to hyperpigmentation, it is especially crucial to pay attention to the aging factors that most directly impact the skin: sun and wind exposure.

The first, simplest, and most important step in hyperpigmentation prevention, and the maintenance of normal melanin levels, is protecting the skin from overexposure to harmful ultraviolet radiation. A broad spectrum SPF of at least 20 should be applied before exposure to sunlight, especially on the face, neck, ears, and dorsa of the hands. These areas are most often exposed. It is no coincidence that these areas are also where hyperpigmentation is most prevalent. While science has not found the ultimate answer, protecting from overexposure can help avoid a host of hyperpigmentation disorders on the highly-visible areas where they most often occur.
Reapplication of sunscreen is crucial to the continued protection of the skin during prolonged periods in the sun, especially after activities or sports. It is recommended that sunscreen be reapplied every two hours, including time spent in the car when the face, neck, and hands are especially vulnerable. Indoor tanning salons should be approached with caution and time outside should be limited between 11 a.m. and 3 p.m., when the sun is most intense. It is also important that the skin remain moist and hydrated during sun exposure to prevent damage. Proper sun protection will not only help prevent certain precancerous hyperpigmentation disorders, but will also help the skin maintain normal levels of melanin, decreasing the chances of redness and freckling.

When choosing a sunscreen, it is important to take into account one’s skin type. For example, those with acneic skin should avoid greasy sunscreens and those with fair skin should look for a slightly higher sun protection factor. While preferences depend on the product's scent, ease of application, and price, the most important factor when choosing a sunscreen is getting the proper SPF. The client’s skin characteristics are also important when considering one’s risk of sunburn, gauged on a scale of six skin types. A Type 1 client always burns and never tans while a Type 2 client burns sometimes and tans with difficulty. Type 3 clients sometimes have mild sunburns and tan about average. These three types, especially Type 1, should be utilizing a high SPF daily. A Type 4 client rarely burns and tans with ease, and Types 5 and 6 never sunburn, easily tan, and experience slight skin irritation with prolonged sun exposure. Even though sunburn susceptibility is low, Types 4 through 6 should still apply a SPF during periods of sun exposure in order to properly protect from hyperpigmentation and
skin damage.

Another factor that should be considered regarding sun exposure is the effect of drugs on the body. Many illicit and prescription drugs, including some antibiotics, are known to increase the skin’s sensitivity to sunlight. Clients should abstain from taking these drugs whenever medically possible, but it is a reality that many prescription medications are necessary. A reaction from sun exposure after taking such a drug can range from something simple like erythema to something more severe, such as bullous eruption. Signs of primary lesions during a reaction can include varying degrees of redness and develop rapidly within two to 10 hours after ultraviolet exposure. Vesiculation occurs in severe cases associated with systemic weakness, chills, malaise and localized pain. A secondary lesion shows scaling and/or peeling and, in some cases, a secondary infection of the skin might occur, posing new risks to the individual. Reactions and subsequent infections can be serious and clients should always exercise proper precautions when using a drug that can increase the skin’s sensitivity
to sunlight.

There are several harmless, strictly cosmetic hyperpigmentation disorders. These range from freckles and melasma to seborrheic keratosis. Seborrheic keratosis can appear serious due to its sometimes melanoma-like appearance, but is a natural part of aging in most clients. While this type of hyperpigmentation is seen mainly after age 50, it can also be seen in highly susceptible clients in their 30s, reinforcing the importance of proper skin protection for this population. Pregnant women can also experience hyperpigmentation, presented as a line on the stomach or melasma. Any change in the skin’s appearance, especially after prolonged sun exposure, should be discussed with a dermatologist for proper diagnosis and treatment.

In addition to protecting against the cosmetic effects of overexposure to the sun, using a broad spectrum SPF, appropriate for the client’s skin type, also helps protect against the harmful forms of hyperpigmentation. Ultraviolet light induces malignancy by causing mutation of cellular DNA and suppressing the immune system’s surveillance of malignant cells. Wrinkling, aging of the skin, and cancer are promoted by injudicious chronic sun exposure, so personal responsibility is important. Genetic factors, such as having a light complexion or the presence of dysplastic nevus, increase susceptibility to sun-related skin damage and should be taken into account. Clients that are genetically predisposed to sun-damage susceptibility should exercise great care when spending time in the sun, as they are at a greater risk for developing premalignant hyperpigmentation.
An ever-increasing number of cancers resulting from overexposure to the sun’s harmful rays are being discovered, with many initially present as various types of hyperpigmentation. For instance, actinic keratosis, a potentially pre-cancerous condition, causes scaly, crusty lesions that can become malignant if left untreated. Actinic cheilitis, also a premalignant condition, involves the degeneration of the tissue of the lips after prolonged sun exposure. Most common in males who spend a significant amount of time outdoors, this type of hyperpigmentation is usually characterized by skin lightening on and around the lip area and the loss of the distinct vermillion border of the lips. Pre-cancerous conditions like these, if left untreated, can lead to malignant melanomas, basal cell carcinomas, and squamous cell carcinomas, all late results of excessive sun exposure.

Treatment of hyperpigmentation varies depending on the condition, severity, and pre-cancer potential. Pre-cancerous areas are biopsied to test for malignancy and proper treatment follows diagnosis. Cosmetic treatments range from topical agents and peels to laser therapy. Hydroquinone has long been widely accepted as the over-the-counter topical of choice for the treatment of hyperpigmentation disorders due to its effectiveness. However, negative side effects have been shown in instances of long-term usage, raising many concerns regarding the safety of its presence in cosmetic products. For example, hydroquinone has been reported to have carcinogenic effects when applied to the skin and is considered to be both cytotoxic and mutagenic. It lightens skin by inhibiting melanin production, which, in turn, increases the skin’s sensitivity to the sun, thereby intensifying UVA and UVB exposure. This increases the overall risk of future hyperpigmentation. Since skin conditions like melasma require indefinite treatment to maintain effect, hydroquinone creates a cycle that can actually leave the client with worsened or increased hyperpigmentation than when the treatment began. Other undesirable side effects include skin irritation, contact dermatitis, leathery skin texture, and exogenous ochronosis, a condition that causes the skin to turn a bluish-black color.

Because of the overwhelming risks involved with using hydroquinone as a treatment for hyperpigmentation disorders, it is highly desirable to develop and create an effective and safe alternative. For the future of topical cosmetic lightening of skin affected by hyperpigmentation, skin care professionals should turn to alkylresorcinols. Alkylresorcinols are present in rye and wheat at levels of 0.015 to 0.3 percent of whole kernel weight and have been studied in food for human nutrition as being of utmost importance. Alkylresorcinols have an 80-year-old history of use and are reported to have anesthetic, antiseptic, and anti-mimetic properties. They are also known to be used to ease discomfort on small skin infections caused by sun damage.

Any product related to the skin, whether it be used for lightening, age reversal, skin protection, or appearance enhancement, must and should be formulated with hexylresorcinol. Hexylresorcinol is considered an amphiphilic phenolic lipid and is present in the grain fractions of rye and other cereals in significant amounts. It has been reported to have antitumor, antifungal, antiparasitic, and antibacterial qualities; interaction of these alkyl tails with phospholipids and/or other proteins creates an antioxidant effect of the phenolic hydrogen. It has been shown to be as effective as hydroquinone for skin lightening, but with none of the described drawbacks. It is also thought to increase protection against UVA and UVB rays and reduce wrinkles and fine lines, adding to its impressive list of benefits.
Hexylresorcinol is a must for all products associated with skin protection against environmental stress, aging, pigmentation, and brown spots. It has been shown to be a very effective inhibitor of the surface browning of many fresh cut fruits, including apples and pears. Hexylresorcinol also has a synergistic effect in the prevention of browning when paired with ascorbic acid. Ascorbic acid in many forms reduces quinones generated by polyphenol oxidase, while hexylresorcinol specifically interacts with polyphenol oxidase. A test with a blend of hexylresorcinol, ascorbic acid, and calcium lactate extended the shelf life of pear slices from 15 to 30 days. It is also reported to inhibit melanosis in shrimp. Hexylresorcinol has a Global Research and Development Services status of being safe and effective for use as an anti-browning agent.

At present, a study is taking place to measure the effects of hexylresorcinol and resveratrol, a natural phenol found in the skin of food sources like grapes and blueberries, against oxidative DNA damage in human lymphocytes induced by hydrogen peroxide. Resveratrol is produced when a plant is under attack by bacteria or fungi. Its photoprotective effects are currently being studied. The inhibition of oxidative damage and human lymphocytes by resveratrol and hexylresorcinol is shown to be due to the increase in glutathione levels and antioxidant enzymes. Glutathione reductase and glutathione peroxidase have shown long-term preservation of DNA in aqueous solution.
Clinical tests were conducted with hexylresorcinol, showing significant improvement over a period of 12 weeks in a double blind, randomized, controlled study. In vivo studies conducted on 65 primarily-Chinese female subjects, ages 30 to 40, incorporated the formula into moisturizing products which showed excellent results. Digital images showed that not only did a skin lightening occur, but pigmentation spots were also reduced and in some cases eliminated. The most surprising factor was that an overall skin improvement occurred insofar as elasticity, moisturization, and anti-aging effects. No overall skin irritation was evaluated and safety of product was established.

Hexylresorcinol, in combination with highly stabilized ascorbic acids and vitamin E, gives the cosmetic scientist unlimited possibilities in creating the ultimate product to fight hyperpigmentation. These ingredients, encapsulated into an alphasomal concentrate, give professionals the possibility of unlimited results. Creation of a safe, effective alternative to current available treatments can help millions living with darkened patches of skin, acne scars, redness, or one of the other various forms of hyperpigmentation to regain self-confidence. Virtually free of side effects, this formulation is the promising future for treatment of hyperpigmentation disorders.

Dieter-Kuster-2014Dr. Dieter Kuster is the founder of CA BOTANA and has developed over 3,000 products for the cosmetic industry and in-house brands, Doctor D. Schwab, Sea Enzyme, and Ambrosia Aromatherapy. During his more than 50 years of experience in the cosmetic industry, Kuster authored many articles for magazines and trade publications and is a sought-after lecturer and speaker for the beauty industry on an international level.


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