title: Dyspigmentation, skin physiology, and a novel approach to skin lightening.
abstract: BACKGROUND
  Even facial pigmentation is considered a universal sign of youth and beauty in all cultures and at all ages in both men and women. The recent FDA concern about the safety of topical hydroquinone has provided the impetus for research into new pigment lightening alternatives in the cosmetic OTC market.
  
  
  OBJECTIVE
  This research examined a novel hydroxyphenoxy propionic acid, ellagic acid, yeast extract, and salicylic acid formulation applied twice daily compared to the standard prescription combination of 4% hydroquinone cream and 0.025% tretinoin cream applied nightly.
  
  
  METHODS
  This single-center investigator-blinded 12 week study enrolled 82 subjects (7 male, 75 female) ages 25-60 years divided into 2 balanced groups of 41 subjects each with one group using a novel hydroxyphenoxy propionic acid, ellagic acid, yeast extract, and salicylic acid formulation applied twice daily compared to the standard prescription combination of 4% hydroquinone cream and 0.025% tretinoin cream applied nightly.
  
  
  RESULTS
  Significant tolerability issues arose with the prescription combinations that were not seen with the cosmetic formulation. In terms of ability to even skin tone, decrease spot intensity, decrease spot size, and improve overall pigmentation, both products demonstrated parity.
  
  
  CONCLUSIONS
  This research demonstrated the value of cosmetic formulations as part of a treatment regimen for pigmentation issues.
authors.affiliation: Dermatology Consulting Services, High Point, North Carolina, USA.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Draelos
authors.forename: Amanda
authors.initials: A
authors.lastname: Dahl
authors.forename: Margarita
authors.initials: M
authors.lastname: Yatskayer
authors.forename: Nannan
authors.initials: N
authors.lastname: Chen
authors.forename: Yevgeniy
authors.initials: Y
authors.lastname: Krol
authors.forename: Christian
authors.initials: C
authors.lastname: Oresajo
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D004311:Double-Blind Method; D004338:Drug Combinations; D004610:Ellagic Acid / Q000008:administration & dosage*; D005145:Face; D005260:Female; D006801:Humans; D006873:Hydroquinones / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010859:Pigmentation Disorders / Q000188:drug therapy*; D020156:Salicylic Acid / Q000008:administration & dosage*; D062327:Skin Lightening Preparations / Q000627:therapeutic use*; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage*; D015003:Yeasts
chemical_list: D004338:Drug Combinations; D006873:Hydroquinones; D062327:Skin Lightening Preparations; D004610:Ellagic Acid; D014212:Tretinoin; D020156:Salicylic Acid; C031927:hydroquinone
keywords: dyspigmentation; ellagic acid; skin lightening