Hydroquinone (HQ) is usually the first-line treatment for patients with hyperpigmentation. However, some animal studies have shown that long term use of this agent may cause side effects. This warrants the need for non-HQ topical formulations with similar efficacy and less adverse effects. A prospective, randomized, controlled split face study was thus conducted to determine whether a non-HQ topical formulation composed of selective growth factors, tranexamic acid, niacinamide, arbutin, and vitamin C could provide similar or improved efficacy to topical HQ, but with a reduced adverse reaction profile. In this study, the safety and efficacy profiles of a proprietary product SKNB19 werecompared with HQ 4% in treating hyperpigmentation.

The study cohort involved 18 adults with facial pigmentation who were randomly assigned to have one side of their face treated with SKNB19 twice a day (morning and night application) and the other treated with HQ4% applied nightly. Patients were asked to use a 5-point scale to self-assess their overall appearance, and a 4-point scale to assess redness, irritation, and tolerability to the skin-brightening creams. The findings of this study published in The Journal of Cosmetic Science showed that SKNB19-treated hyperpigmentation had a statistically significant improvement in the overall appearance of hyperpigmentation and was reported to be 28.5% better than HQ4%-treated skin in the patient self-assessment and 27% better than HQ4%-treated skin in the independent reviewer assessment. On pair-wise comparison, the independent reviewer assessment also demonstrated that 88.2% of the SKNB19-treated sides appeared equal or better than the HQ4%-treated sides. It is noteworthy that 1 patient left the study due to severe intolerance to HQ4% while none experienced intolerance to SKNB19, and all were able to continue it without side effects. Moreover, SKNB19-treated hyperpigmentation also had a statistically significant reduction in irritation in comparison to HQ4%-treated hyperpigmentation. Patients also reported a reduction in redness when using SKNB19 in contrast to HQ4%.

This study thus suggests that SKNB19 is an effective and safe option for improving hyperpigmentation. Itremarkably improved the appearance of hyperpigmentation when compared with HQ4% in patient self-assessment as well as independent reviewer assessment. Italso exhibited a lower adverse reaction profile and was significantly better tolerated than HQ4%. Therefore, SKNB19 should be considered as a safe and effective non-HQ alternative for management of hyperpigmentation.

J Cosmet Sci. Sep/Oct 2020;71(5):263-290.