Decoding Cosmetics Claims: Skin Lightening Cream

Skin lightening creams — also called fade creams, brightening creams, skin-tone correctors, or bleaching creams — are designed to reduce skin discoloration or hyperpigmentation caused by sun exposure, age, disease, or acne. But do they work? And what are the side effects associated with the ingredients?

What do the ads say?

Advertisements and labels for skin lightening promise to “[erase] past damage,” “[fade] dark spots and discolorations,” and “lighten and brighten skin tone.”

Check out this advertisement for Clinique Even Better Clinical Dark Spot Corrector, which claims a 53% improvement in evening skin tone. (Pssst: “clinical” is one of those fluffy unregulated words like hypoallergenic that really don’t mean anything.)

Overseas, skin lighteners promise to whiten skin. Here, whitening creams are more often marketed as a solution to help “brighten” skin rather than “whiten,” but for better or worse, many people of color still use them to lighten their overall skin color.

What’s in them?

• Hydroquinone – Hydroquinone inhibits an enzyme involved in the production of melanin, which gives skin its pigment. It is effective, but comes with risks that users should be aware of: increased sensitivity to sunlight, permanent skin discoloration, liver damage, and neuropathy. Other things to keep in mind: Hydroquinone results appear to plateau at around four months of regular use. It should not be used in combination with benzoyl peroxide or resorcinol. The ingredient has been banned as a skin lightener in England and several EU countries, and the FDA is also considering a ban of over-the-counter hydroquinone.
• Kojic Acid – Kojic acid works similarly to hydroquinone to inhibit melanin production. While effective, it can make skin more sensitive to sunlight and prone to irritation. 
• Alpha Hydroxy Acids (AHAs) – AHAs help with skin discoloration by exfoliating the top layer of skin and speeding up cell turnover rates. Most products available directly to consumers, however, do not contain a high enough concentration of AHAs to significantly improve hyperpigmentation when used alone. The typical over-the-counter cream contains 4-15%, but the best results will come from a professionally applied, high-concentration peel, which come in strengths around 30-70% and must be repeated every two-to-three weeks. AHAs can cause irritation and sensitivity to sunlight.
• Azaleic Acid  – Azaleic acid is often prescribed as an acne treatment, but it’s also used to treat hyperpigmentation. The effectiveness of a 20% concentration is comparable to that of a 2% concentration of hydroquinone. Azaleic acid can be used alone or in combination with 15-20% glycolic acid. Side effects include skin irritation and sensitivity to sunlight.
• Retinoids – Retinoids are vitamin A derivatives that help speed up cell turnover. They can be used alone or in combination with hydroquinone. Risks include skin irritation and increased sensitivity to sunlight.
• Plant Extracts  –  Several alternative treatments for hyperpigmentation are available. They include madder extract,  bearberry extract,  mulberry,  white mulberry, paper mulberry, and arbutin. All of these, however, break down into hydroquinone when absorbed into the skin.

Other Possible Risks

While U.S. cosmetics are strictly regulated, there are many imported creams on the market that may contain harmful undisclosed ingredients, like mercury or steroids, or higher concentrations of active ingredients than are safe. It’s best to steer clear of these products entirely.

Bottom Line

The many treatments for hyperpigmentation appear to be about as effective as advertisements claim them to be, but all come with risks and should be used with care. The best advice, in the end, appears to be wear sunscreen.