There are generally three different types of skin lightening treatments. They are typically used to treat pigmentation issues, although in some cultures they are used simply for cosmetic purposes. The most common skin lightening treatment is topical skin whitening cream or gel. It can be made from several different primary ingredients and is usually coupled with sunscreen and a topical retinoid for optimal effect. When this skin lightening treatment fails to work, cryosurgery and laser treatments can also be options.
The most common topical ingredients used for skin lightening are hydroquinone, mequinol, azelaic acid, kojic acid, and derivatives of certain mulberry plants. Hydroquinone, which has been banned in Europe for its possible connection with leukemia, inhibits the skin's ability to make melanin, which is what gives skin its color. When its strength is at 2%, it has been proven effective in treating pigmentation issues and reducing the overall color of the skin. While available in 4% strength, this amount of hydroquinone can be dangerous.
A skin lightening treatment that contains mequinol, which also inhibits melanin production, is believed by many researchers to be a safer alternative to hydroquinone. Azelaic acid, typically used at 20% strength, has also been shown to work as a skin lightening treatment, though it is not usually as effective as hydroquinone and mequinol. Kojic acid, commonly found in Asian countries, is a highly effective cosmetic whitening treatment, although it is an unstable substance and therefore can be expensive. For a more natural skin whitening treatment, derivatives of the mulberry plant can be used; it tends to have the same effect on the skin as hydroquinone, but without the side effects. These skin lightening lotions and gels work best when sunscreen is regularly applied, and hydroquinone and mequinol are best when coupled with a topical retinoid cream.
When skin lightening creams fail to work, cryosurgery — which uses liquid nitrogen — may be an appropriate skin lightening treatments for people of all skin tones. The liquid nitrogen causes melanin to rise to the surface of the skin and then peel off a few days later. This treatment is best done on small areas of skin and does carry the risk of increased pigmentation issues.
Laser treatments have also been effective when used as a skin lightening treatment. While not recommended for those with darker skin, it can significantly improve the evenness of skin tone, although it can also produce hyper-pigmentation in some patients. Laser treatments are best to reduce dark spots and are not typically recommended for whitening the entire face.
Each skin lightening treatment can be used for different purposes. Creams and gels are most often for an overall lightening effect, while laser treatments and cryosurgery are typically used for reducing the appearance of dark spots. As with any cosmetic treatment, there are certain risks; any skin lightening treatment should be discussed with a dermatologist or primary care doctor beforehand.