The clinical benefit of a multimodal topical approach to treating skin dyspigmentation.

BACKGROUND: The recent removal of hydroquinone from the over-the-counter market has created a need for modern skin lightening formulations. An effective pigment lightening formulation must be non-irritating to prevent skin darkening from post-inflammatory hyperpigmentation, penetration enhanced to reach the epidermal/dermal junction, contain anti-inflammatory ingredients, and address multiple mechanisms of pigment production.

OBJECTIVE: The objective of this research was to demonstrate the efficacy of a topical multimodal pigment lightening preparation containing tranexamic acid, niacinamide, and licorice.

METHODS: Fifty female subjects 18+ years of all Fitzpatrick skin types with mild to moderate facial dyspigmentation were enrolled. Subjects were provided with the study product for twice daily use on the entire face and an SPF50 sunscreen with evaluations occurring at Week 4, Week 8, Week 12, and Week 16. The investigator used a face map to identify a pigmented target site on the face for dermaspectrophotometer (DSP) measurement. The dermatologist investigator completed a baseline facial efficacy and tolerability assessment. The subjects completed a tolerability assessment.

RESULTS: 48/50 subjects completed the study without tolerability issues. The DSP readings demonstrated a statistically significant reduction in target spot pigmentation at Week 16. The investigator assessed a 37% decrease in pigment intensity, a 31% decrease in pigment extent, a 30% decrease in pigment homogeneity, a 45% improvement in brightness, a 42% improvement in clarity, and a 32% improvement in overall facial skin dyspigmentation at Week 16.

CONCLUSION: The combination of penetration enhanced tranexamic acid, niacinamide, and licorice was effective in inducing facial pigment lightening.