Approach to Skin Lightening in Patients With Melasma

September 2018 | Volume 17 | Issue 9 | Editorials | 1018 | Copyright © 2018

Philip R. Cohen MD

Department of Dermatology, University of California San Diego, La Jolla, CA

Abstract

I read with interest the informative article by Spencer et al1 that describes the efficacious use as a novel skin lightening agent (LumaPro-C) for the treatment of patients with melasma.

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I read with interest the informative article by Spencer et al1 that describes the efficacious use as a novel skin lightening agent (LumaPro-C) for the treatment of patients with melasma. The topical preparation contains not only a resurfacing peptide with stabilized vitamin C and botanicals (including resveratrol, daisy and pine extracts, and ginger extract), but also an encapsulated plankton extract and a probiotic regulator. The components of the researchers’ preparation promoted skin lightening by exfoliation, impeding melanogenesis, and reducing inflammation.Table1Seventeen women with facial melasma used the LumaPro-C cream and sunscreen on one side of their face and a placebo preparation and sunscreen on the other side of their face for eight weeks. The investigators observed an objective decrease in hyperpigmentation on the treated side versus the control side: 14.60 percent as compared to 9.82 percent. There was no significant irritation.1The topical management of melasma usually incorporates the use of sunscreen. Spencer et al1 also included sunscreen as a topical adjuvant agent for the women they treated. However, since 1975 when Drs. Kligman and Willis described their topical formula (which included 5% hydroquinone, 0.1% tretinoin, and 0.1% dexamethasone) for depigmenting human skin, other topical agents have been concurrently or separately used to treat melasma with variable success.2Similar to Spencer et al,1 I recently proposed a novel topical approach for the management of melasma for which the active agents target etiologic factors in the pathogenesis of the condition: estrogen and angiogenesis.3 Specifically, the topical agent contains an anti-estrogen and a vascular endothelial growth factor inhibitor. In addition to this double-drug topical therapy, triple-drug (by adding hydroquinone) and quadruple-drug (by also adding a sunscreen) therapy may be provided (Table 1).In conclusion, new topical agents and physical modalities continue to expand the therapeutic armentarium for managing patients with melasma. Individual and combination topical treatments directed at various etiologic factors of melasma may provide greater success in achieving depigmentation. The concurrent use of my novel topical agent and that of Spencer et al1 may warrant further investigation to improve the observed skin depigmentation in melasma patients.

Disclosure

The author has no financial relationship with industry or potential perceived conflicts of interest as relevant to the manuscript.

References

  1. Spencer JM, Accioly J, Kitchen N. Double blind, placebo controlled evaluation of a novel skin lightening agent. J Drug Dermatol 2018;17:113-115.
  2. Kligman AM, Willis I. A new formula for depigmenting human skin. Arch Dermatol 1975;111:40-48.
  3. Cohen PR. Melasma treatment: A novel approach using a topical agent that contains an anti-estrogen and a vascular endothelial growth factor inhibitor. Med Hypotheses 2017;101-1-5

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