DISCUSSION
In an effort to inhibit melanin production at the multiple pathways involved in skin pigmentation, currently available prescription and nonprescription products often include the use of several topical agents including the adjunctive use of retinoids, AHAs, moisturizers and/or hydrating serums to enhance overall efficacy and minimize adverse effects.3,14,18,19,20-28 This systembased approach requires consumers purchase and use multiple products in order to achieve optimal results. This not only necessitates adherence to complicated regimens, but these regimens can also be quite costly.
ETCS was developed to address the need for an efficacious, streamlined approach to the treatment of hyperpigmentation and other concerns associated with photodamage skin, such as redness and age-related yellowing of the skin, skin tone, and fine lines and wrinkles. The synergistic blend of ingredients contained in ETCS were identified to comprehensively inhibit melanin by addressing the primary pathways of melanin production and improve the overall quality of skin (Table 2). For example, in addition to inhibiting ROS and melanin production at several levels, Diglucosyl Gallic Acid brightens skin tone and reduces the appearance of redness. Derived from the Australian Kakadu plum, Terminalia Ferdinandiana is a potent form of vitamin C that reduces oxidative stress in the skin, brightens skin, and also enhances collagen and hyaluronic acid, thus contributing to improvements in tone, evenness, redness, and wrinkles. ETCS effected early, significant reductions from baseline in the appearance of dyschromia based on expert and biometric assessments. Hyperpigmentation is often accompanied by other concerns associated with cumulative sun and environmental exposures, including changes to skin texture, color, and the development of fine lines and wrinkles. In addition to brightening and evening skin tone, visible improvements in skin texture, erythema, fine lines/wrinkles, and pore size were observed leading to enhanced global appearance in the quality of skin as a result of the multi-functional properties of its ingredients. Importantly, efficacy outcomes mirrored subject satisfaction, with subjects reporting high levels of satisfaction in improvements in overall appearance, evenness, brightness, tone, lightening of dark patches, and discoloration of skin. Progressive improvements were observed with continued use through week 16 in all categories measured.
AHA-Ret also contains glycolic acid to support exfoliation of skin which is vital in the removal of melanin from the epidermis, as well as ingredients that help soothe, hydrate, protect and rejuvenate skin.17
Differences in sample size between the treatment groups, severity and ethnicity limited the ability to draw comparisons between the two treatment groups.