Hydroquinone is the gold standard for treating hyperpigmentation in dermatology. Its effectiveness and safety is so well-documented in clinical studies that almost all dermatology providers will recommend 4% hydroquinone as a first step for anyone with significant pigment concerns.
In this case, turning to dermatological procedures will work as the fastest way to get rid of hyperpigmentation. Chemical peels, laser therapy, microdermabrasion, or dermabrasion are all options that work similarly to rid skin of hyperpigmentation.
Your dermatologist can help you identify the cause of your hyperpigmentation and work with you to develop an appropriate treatment plan. No matter what treatment you ultimately choose, it's important to protect your skin from further sun damage and hyperpigmentation.
Hydroquinone is considered by many to be the gold standard treatment for pigmentation. “Hydroquinone blocks the production of pigmentation by inhibiting tyrosinase,” explains Dr Jack, adding that it does so in a particularly potent way.
Some cases of hyperpigmentation may never go away completely. If hyperpigmentation is caused by injury, then as the skin heals the discoloration will lessen as melanin is absorbed into the tissue surrounding the injury.
“If the retinol you're using is too strong for your skin causing inflammation, darker skin tones may have a higher risk of discoloration, or hyperpigmentation, from the use of it," she adds. Dr. Icecreamwala recommends starting with a retinol that is 0.3 or 0.5 percent.
Retinoids are useful in the treatment of hyperpigmentation because they reduce epidermal melanin by blocking the transcription of tyrosinase, induce desquamation, disperse keratinocyte pigment granules and enhance epidermal cell turnover via epidermopoiesis.
It helps fade hyperpigmentation
Vitamin C inhibits melanin synthesis by downregulating the activity of an enzyme known as tyrosinase. It's widely used in dermatology for depigmentation of hyperpigmented spots on the skin.
Retinol can be effective in lightening the skin and reducing the appearance of dark spots. It does so by promoting skin shedding, which improves cell turnover rate and hinders the activity of the enzyme tyrosinase, which encourages the production of melanin.
Glycolic acid peels are considered a safe and effective treatment for a variety of skin conditions, including acne, hyperpigmentation, and photoaging. Medium-strength peels are done by board-certified dermatologists or by licensed cosmetologists or aestheticians.
Tretinoin is a more potent retinoid than retinol and will show results faster. While these active ingredients both combat signs of photoaging (aka wrinkles, rough skin, uneven skin tone, and enlarged pores), tretinoin-based products like Night Shift are more effective for fighting acne.
So, should I use vitamin C or retinol for wrinkles? Well, when it comes right down to it, the choice is really in what you're looking to do for your skin. While vitamin C is incredible for the skin because of its ability to help brighten and improve hyperpigmentation, the best active ingredient for wrinkles is retinol.
First, vitamin C works to help improve the look of dark spots, fine lines, wrinkles and sagging skin. Then, retinol steps in to help improve skin's elasticity. The result is that retinol and other retinoids may help improve skin's texture while helping to minimize the look of fine lines.
L-cysteamine is a topical antioxidant that effectively evens hyperpigmentation. You can get it from some doctors' offices or online by prescription. Tranexamic acid can be taken as a pill or applied as a topical to improve melasma. It's an option for people who don't see improvement with other forms of therapy.
Best overall vitamin-C serum
Four of our dermatologists recommend SkinCeuticals C E Ferulic, which they (and our editors) hail as the gold-standard vitamin-C serum and is suitable for all skin types.
What It Does: This potent antioxidant interferes with the production of pigment in the skin, fading dark spots. When You'll See Results: Once you add vitamin C to your skincare regimen, you may start seeing noticeable improvements in three weeks. It can help significantly fade hyperpigmentation in about two months.
Salicylic acid decreases postacne hyperpigmentation by its anti-inflammatory effects. Ahn and Kim[18] found salicylic acid to have a whitening effect on the skin as well. Mandelic acid also has a beneficial effect in improving skin pigmentation.
Pigmentation loss as a result of skin damage: If you've had a skin infection, blisters, burns, or other trauma to your skin, you may have a loss of pigmentation in the affected area. The good news with this type of pigment loss is that it's frequently not permanent, but it may take a long time to re-pigment.
Peer reviewed studies suggest you should consult your doctor if you're not seeing any results by week 12. In patients with sun-damaged skin, improvements in the skin usually are seen within the first 3-4 weeks of treatment. Brown spots begin to fade after 6-8 weeks.
Myth: You'll see results in 4 to 6 weeks
For over-the-counter retinol, it can take up to six months and with tretinoin up to three months for full results to be visible.
Retinoids work best if you use them daily. Specifically, they should be used at night because some types are deactivated by light and air. It's important to start slowly and allow your skin time to adjust. Using too much too quickly can cause redness, dryness, and irritation.
"You can use tretinoin or [over-the-counter] retinols forever."