Depigmenting lotion treatments

Depigmenting lotions are topical preparations that reduce pigmentation by interfering with the process that makes it - either by inhibiting the enzyme that produces melanin, by reducing its transfer into surrounding skin cells, or by accelerating the turnover of already-pigmented cells.

They are used on their own and, more often, alongside in-clinic treatments - before, to prime the skin and reduce the chance of the treatment itself triggering pigmentation, and after, to hold the result.

What they are used for

Hyper-pigmentation
Melasma - where topical treatment is usually the foundation of the whole plan rather than an add-on
Post-inflammatory pigmentation after acne, injury or treatment
Age spots and freckles
Uneven skin tone
Preparing skin before, and supporting it after, peels, laser and needling

What is in them

Depigmenting preparations combine several agents, because attacking pigment production from more than one direction works better than any single ingredient. Commonly used agents include vitamin C, niacinamide, azelaic acid, kojic acid, arbutin, tranexamic acid and retinoids.

Some effective depigmenting agents are prescription-only medicines in Australia and require a doctor's consultation. Prescription-only medicines cannot be named or promoted in advertising to the public, which is why you will not find them listed by name here.

Assessment first

Pigmentation looks alike whatever its cause, and treatment differs by cause. Consultation establishes whether this is sun-related pigment, melasma, post-inflammatory pigment or something else, and whether the pigment sits superficially or deeper - superficial pigment responds far better to topical treatment.

Any pigmented patch that is new, changing, irregular or unlike the others on your skin is examined before treatment rather than covered with a cream. See skin cancers.

Sun protection is not optional here

Depigmenting agents slow pigment production. Ultraviolet light stimulates it. Using one without the other is working against yourself, and visible light matters too - which is why a tinted or mineral sunscreen containing iron oxides is often recommended for melasma.

Daily broad-spectrum SPF 50+ during a course of depigmenting treatment does more for the result than any change of product.

Timeframes

Topical pigment treatment is slow. Expect:

4-6 weeks before any change is visible
3-6 months for the fuller effect
Ongoing maintenance afterwards, because pigment returns when the driver - sun, hormones - continues

Some agents are used in cycles rather than continuously, and your practitioner will tell you which applies to what you have been given.

What results are realistic

Superficial pigmentation usually lightens considerably. Deeper (dermal) pigment responds slowly and often only partially. Melasma lightens and then commonly returns - it is managed rather than cured.

Topical treatment reduces pigmentation; it does not bleach skin to a different tone, and should not be described as "whitening". Individual results vary.

Risks

Irritation, redness, stinging, dryness and peeling - common in the first weeks
Contact dermatitis or allergy
Post-inflammatory pigmentation from the irritation itself - the main reason to introduce these products gradually, particularly in darker skin
Uneven lightening, or a halo of paler skin around a treated patch
Increased sun sensitivity
Rebound darkening when treatment stops without maintenance
Incomplete response, particularly with dermal pigment

Several depigmenting agents are unsuitable in pregnancy and breastfeeding - tell your practitioner. See risks and complications.

Cost

Products are priced individually. As at September 2024 and including GST, a skin assessment is $50 and a Cosmetic Doctor consultation is $150 - required where a prescription agent is appropriate. Not covered by Medicare.

Booking

Me Clinic, 4 Burke Road, Malvern East VIC 3145. Phone 1300 852 050 or (03) 9569 3511, or use the online consultation form.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.