When there are so many scar treatments to choose from, how do you know which one is best for you? Certainly some scar treatment ingredients work better than others. Then there’s the safety issue. The last thing you want is a scar treatment that’s going to cause you to break out in a rash! For dark scars and hyperpigmented skin lesions (like brown spots and dark acne scars) one of the following treatments is typically recommended:
1) Hydroquinone
2) Kojic acid
3) Vitamin C (ascorbic acid)
4) Natural scar treatments such as Licorice extract
Hydroquinone can be very effective in helping to fade dark scars and hyperpigmented skin blemishes. However, it is no longer sold in some countries because of concerns that long-term use may be dangerous. Hydroquinone can lead to a condition called Ochronosis, even at its over-the-counter strength of 2%. Ochronosis is permanent hyperpigmentation with sooty darkening of the skin. Ochronosis may also cause loss of skin elasticity and impaired wound healing. Other side effects of hydroquinone include contact dermatitis (rash, redness, itching and flaking) and nail discoloration. Some researchers have questioned whether hydroquinone may even cause cancer. As a result of these fears, hydroquinone is only available by prescription in Europe and it is highly regulated in Asia. The skin-lightening effects of hydroquinone also decrease with prolonged use and with sun exposure. Hydroquinone does not improve any other aspect of the scar other than the dark pigment.
Kojic acid also helps fade the dark pigment seen in dark scars and other skin lesions like melasma and brown spots. While it is not as effective as hydroquinone, the popularity of kojic acid has increased over the years as people have become more fearful of hydroquinone’s potential side effects. Kojic acid is also more “natural” as it is produced by several different types of fungi. Once again, there is no improvement in scar healing except for lightening of hyperpigmentation.
Various forms of vitamin C have been shown to fade hyperpigmentation effectively without the side effects associated with hydroquinone or kojic acid. L-ascorbic acid and other vitamin C esters also normalize collagen production after skin injury, leading to more organized collagen formation closer to that seen in normal, uninjured skin. This makes vitamin C a very good scar treatment in general. Brown or dark yellow vitamin C skin care products should be avoided though. The coloring is used to disguise the fact that the vitamin C becomes unstable over time, oxidizes and becomes completely ineffective (vitamin C turns brown as it oxidizes). Products using STABLE vitamin C are typically white as there is no fear of the vitamin C becoming oxidized and ineffective.
Like vitamin C, licorice also makes an excellent scar treatment: it has strong anti-inflammatory properties and accelerates skin renewal. Both vitamin C and licorice inhibit tyrosinase, the enzyme that causes pigmentation with sun exposure and skin injury. Interestingly, licorice boosts the scar lightening effects of vitamin C so the two should be combined for best results. As a bonus, licorice also has anti-acne effects (both prevention and treatment).
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