The annual meeting of the Taiwanese Dermatological Association is always a very exciting event! The meeting features many dermatologists sharing various skin-related treatments and discussing new treatment methods, allowing participating physicians to acquire a great deal of new knowledge. Recently, the new depigmenting active ingredient “cysteamine” has been a topic of discussion. “Cysteamine” effectively lightens pigmentation and spots and makes the skin more translucent, generating a great deal of interest among dermatologists. This time, four dermatologists were specially invited to share the current applications of cysteamine in skincare products.
In the past, the most common ingredients in whitening and spot-fading products were hydroquinone and retinoic acid. However, studies have found that hydroquinone is toxic to pigment cells, and there are safety concerns about its long-term use. In addition, retinoic acid is photosensitizing and highly irritating to the skin, so sun protection is necessary when using it, and it is not suitable for all skin types. Cysteamine, an ingredient that has received much attention in recent years, is an antioxidant that is naturally produced by the body. However, because cysteamine is a very unstable substance, even though it was found to have significant spot-fading and skin lightening effects in the 1960s, it could not be made into a topical skin product. Recently a Swiss dermatologist has finally discovered a new method of cysteamine stabilization, allowing the development of a new type of cream to lighten pigmentation when applied to the human skin. According to research, cysteamine inhibits the enzyme tyrosinase and also stimulates pheomelanin production, producing highly effective results in spot and pigmentation lightening. From a physician’s perspective, long-term use can make melanin more stable and can also reduce the risk of skin darkening after laser treatment, improving postoperative satisfaction and providing a new skin-lightening choice for people with sensitive skin!
Melasma can be tricky and challenging to treat. Many approaches to treating melasma have been adopted around the world, including laser, chemical peels, or taking oral whitening agents and having dietary supplements. However, not everyone can get the desired results. For example, if hydroquinone is applied for a prolonged time, it may cause increased darkening of the skin, while traditional Kligman’s formula contain steroids and retinoic acid, which can cause skin irritation and thinning. If patients have a poor outcome after receiving laser treatments, I recommended they use cysteamine cream at home. In addition to reducing the risk of darkening after treatment, cysteamine cream aids the effectiveness of the treatment. Cysteamine cream can also be used at home for other pigmentation issues such as post-acne pigmentation marks and is very effective in reducing acne induced hyperpigmentation.
In my clinical experience, in addition to the dullness and uneven pigmentation of the face, many people also want to improve the uneven skin tone of the body. For example, after the liposuction of the legs, women will find dark spots of hyperpigmentation develop behind the knees that are very difficult to lighten. I have also encountered mothers whose areolas and nipples became darker after breastfeeding, while young girls who like to wear miniskirts or hot pants in summer are very concerned about pigmentation below the buttocks. All of these problems can be improved by using cysteamine cream, and results can usually be seen after four months of continuous use. Cysteamine cream is also a new alternative for some patients with sensitive skin who are unable to have laser treatment.
Melasma can be exacerbated by many factors, including UV rays, blue light, work habits, and stress, and may even be caused by genetic factors. These factors increase the required treatment time. For patients with severe melasma, in my clinical practice I usually adopt a combined treatment approach, such as picosecond laser treatment, oral tranexamic acid, together with ingredients that can be used at home to lighten pigmentation. Azelaic acid, kojic acid, or the new depigmenting ingredient cysteamine are all good choices. After the treatment has produced a certain level of improvement, it is important to maintain the result, including daily sun protection and a home care regimen. Long-term use of skincare products with cysteamine for as little as 15 minutes a day can stabilize melanin production, lightening spots and making the skin tone more even and translucent.
In fact, using cysteamine cream alone works very well, and user satisfaction is very high. However, many consumers want to see results as quickly as possible. Therefore, a combination of treatments is recommended. In addition to basic daily sun protection, medical aesthetics can be done through methods such as laser treatments and peels, as well as oral whitening agents, such as taking vitamin C and tranexamic acid. For home care regimens, I recommend cysteamine cream. Cysteamine is one of the most powerful antioxidants naturally found in the human body. It is scientifically proven to be effective in reducing pigmentation and can also be used at home in conjunction with other treatments. It gives physicians more confidence in their treatment and gives consumers more noticeable results, without having to worry about side effects from long-term use, such as hyperpigmentation rebounce or severe skin irritation.
Brightening and spot lightening and achieving an even skin tone have always been issues that Asians are particularly concerned about. For Taiwanese women, UV rays are the biggest cause of skin spots. There are actually many types of spots, including epidermal, dermal, and mixed types, as well as acne marks caused by acne inflammation. These spots must be diagnosed by a professional dermatologist prior to treatment. A combination of treatments such as laser treatment, peels, whitening creams, and ultrasound infusion, along with a home maintenance regimen, can effectively reduce spots and pigmentation.