By Debra Jaliman, MD
Skin brighteners are increasingly in the news as more and more companies bring out their own versions, some inexpensive and others costing exorbitant (and absurd) sums of money. Even the New York Times ran a recent article about them, although it repeated some common misconceptions. So let’s go over what skin brighteners can and can’t do.
First of all, in most cases skin brighteners really do improve brown spots and uneven skin discoloration. The most effective ingredient is hydroquinone, but some people react to it and it has been banned in some countries because of the risk of ochrinosis, a rare but usually irreversible blue or black hyperpigmentation of the skin. Most skin brighteners now use milder ingredients, such as vitamin C or vitamin B derivatives or plant extracts. Even if these products don’t always succeed at totally erasing brown spots, skin usually looks much better and more even, with a heightened glow.
What people don’t realize is that their beauty routine may have a lot do with how effectively the skin brightener works on their skin. The more exfoliated the skin, the better the skin brightener will penetrate. Those new skin cleansing gadgets that use sonic technology remove a lot of dead skin cells that block the active ingredients of skin brighteners. An exfoliating cream or serum, one with retinol or glycolic acid, does the same thing. Even better is getting a microdermabrasion or mild chemical peel, which by removing more layers of skin allows the skin brightener to penetrate deeper.
No matter how good their ingredients are, skin brighteners will not work if they are not combined with a broad -spectrum sunscreen, preferably one with zinc oxide or titanium dioxide which not only protects against burning but also against pigment changes. And once brown spots or uneven coloring are gone, people must continue to use broad-spectrum sunscreens, or they will just reappear.
Skin brighteners can be used by people of all ethnicities, and most are very happy with the results. Unfortunately, some brown splotches simply won’t go away. That’s because the dark pigment is very deep in the skin layers and products just don’t penetrate. If that’s the case, no need to despair, because there are other procedures a dermatologist can do.
For fair-skinned patients, the Fraxel laser can get rid of about 80% of the pigmentation in one session, and the rest in a follow-up one month later. The only problem is that the area will be red and swollen for about a week. Clear + Brilliant is a new alternative that works on all skin types. Essentially, it is like a mini-Fraxel treatment. The skin is only red for about one day, but takes more sessions, since it is not as powerful as the Fraxel.
And finally, the Medlite laser is a great alternative and one that can also be used on all skin types. The greatest benefit is that there is no redness or swelling at all, but it also takes several sessions.
Bottom line: Try skin brighteners if you have brown spots or blotchy skin, and if they don’t work, go on to laser treatments.