Hydroquinone alternatives seek to address hyperpigmentation

Key Points

Omaha, Neb. - When it comes to skin-lightening, hydroquinone remains the gold standard, offering efficacy in reducing melanin hyperpigmentation. But various factors have given rise to interest in alternatives to hydroquinone.

While none offers the efficacy of hydroquinone and few stand out as being significantly more effective than the others, there is no shortage of options.

"At this time, most of the non-HQ (hydroquinone)–containing products are about on par with each other, and while none are quite as good as hydroquinone, they are pretty good on their own merits," says Joel Schlessinger, M.D., a dermatologist in Omaha, Neb. "Some of their ancillary systems make a difference to patients and I always like to keep patients on one regimen if possible, to make things simple."

Hydroquinone should be used only for short periods and should not be used during pregnancy, so the market is ripe for non-HQ products.

Non-hydroquinone options

Dr. Schlessinger says the main products his practice dispenses to patients include the NeoCutis Perle and Lumixyl product lines. Both feature products that target the melanocyte enzyme tyrosinase.

"Both of these have proprietary ingredients that offer a benefit while not having any hydroquinone in the mix," he says. "(NeoCutis) Perle contains Melaplex, which minimizes tyrosinase activity with phenylethyl resorcinol, leucine, undecylenoyl phenylalanine and sodium glycerophosphate. And Lumixyl's technology involves peptides which directly inhibit tyrosinase."

Syneron has recently launched its elure product, containing Melanozyme, which decomposes melanin. When a short hydroquinone treatment is acceptable, Dr. Schlessinger says NeoCutis's Blanche can be effective.

Tretinoin treatments

Some studies have indicated tretinoin to be effective in treating pigmentary issues, and several new formulations of the product are gaining favor for patients who don't have drug coverage, Dr. Schlessinger says. "We sell Refissa, a form of tretinoin that is 0.05 percent cream, as well as Kinerase (Pro+Therapy, tretinoin gel 0.05 percent), and both provide a very nice price-point in comparison to many of the Rx alternatives," he says.

Chemical peels are favorable alternatives to hydroquinone, he adds. "Peels continue to be popular, and there is a move back to peels in some cases due to the overhype of dermabrasions. Obagi has come up with a new, lighter peel that we are happy with and seems to be popular. Additionally, we like the benefits of several other peels from PCA Skin. And Lumixyl has a system called SilkPeel that goes along with its product, as well as a patented peel that works great."