Getting rid of hyperpigmentation after Acne vulgaris is a major problem, as most people are left with dark marks, once the acne has subsided.

The hyper-pigmentation associated with acne is of the worst kind as it is caused by inflammation of the sebaceous gland, which is located deep in the dermis.

This leads to leakage of pigment cells, called Melanocytes into the dermis, where the dark pigment melanin gets deposited, resulting in patchy, dark spots.

Conventional Medical treatment for Acne is not focused on Hyperpigmentation & often dismissed by Dermatologists as legitimate suffering.

Nothing can be further from the truth!

Early treatment of Acne is essential because inflammation has to be rapidly controlled as a first step.

Once hyperpigmentation is established, the treatment becomes much more difficult especially in dark skins.

Treating hyperpigmentation now requires two things to happen simultaneously:

Firstly, to remove the epidermis slowly (exfoliation) to get rid of the

melanin-carrying cells from the top layer of skin.

Secondly, it allows the Melanocytes that are lurking deep in the skin to be accessed and thereby inhibited by the Skin Lighteners.

There are two main types of exfoliators:

• Fruit Acids- These dissolve the skin keratin & allow the skin cells to be shed.
• Retinoids- These work by increasing surface skin cell production and pushing the cells off the epidermal layer.

Secondly, you need to Inhibit Melanin production:

These are chemicals, which block melanin production or transport by different mechanisms.

It is important to use them in combination so that Melanin can be controlled at multiple locations in its production.

Well-documented and validated ingredients by peer-reviewed clinical studies include Alpha and Beta Arbutin, Kojic Acid, Vitamin C, Octadecene Dioic acid, Azelaic acid, Phytic acid, Licorice & Niacinamide.

It is important to point out that getting rid of hyperpigmentation from acne is going to take at least 3-6 months with effective sun screening.

Immediate results are not possible because the pigment has to be gently teased out of skin or else, there is a risk of provoking even more hyperpigmentation.

Lightenex® Gold serum has been designed to tackle these stubborn stains which are often blue-grey in colour and buried deep in the skin.

It combines:

Exfoliants:

Retinoid, Retinaldehyde & Glycolic acid

                            &

Powerful Skin lighteners:

Kojic acid, Alpha and Beta Arbutin, Dioic acid, Vitamin C, Phytic acid, Azelaic acid.

Lightenex® Gold serum is now considered one of the most powerful

Skin Lightening serum to treat Hyperpigmentation and is recommended by over 5,000 leading Dermatologists worldwide.

For more information, check out www.Lightenex.com

Are you too self-conscious of the dark marks that are left after your Acne has subsided?

Are you finding it difficult to face people in public or even date your ideal partner?

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Lightenex® Gold serum is recommended by leading Dermatologists to treat Hyperpigmentation from Acne.

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This is a very distressing & common condition in dark-skinned people and leads to dark, velvety patches in arm pits, groin, neck, elbows, knees, knuckles or skin folds.
These dark patches often have skin tags with them.
The most common reasons are Obesity (being overweight), Diabetes or hereditary.
This familial or hereditary type presents at birth or early childhood.

The top layer of skin, namely, the epidermis begins to rapidly reproduce.
However, these cells die, but unfortunately stick together and are not shed from the surface.
These clumps of dead cells contain mainly keratin, which is a protein that forms your hair & nails.
Unfortunately in dark-skinned people these new skin cells have more melanin. This increase in melanin, produces a patch of skin that is darker than the surrounding skin. Most people just see darkening and thickening of skin but itching may sometimes occur.

Firstly, to manage this condition is weight loss.
This will help in reducing the new skin cell formation.
A strict programme of diet & exercise has to be followed.
Secondly, it is important that the thick layer of keratin, which contains the melanin is removed. This can be done using alpha hydroxyl acids such as Glycolic acid & lactic acid.
Salicylic acid, which is a beta hydroxyl acid is also useful.
Mandelic acid can also be used.
Retinoids are of limited benefit because they do not dissolve the keratin but accelerate the production of new epidermal cells.
Thirdly, the melanin production has to be stopped. This requires ingredients such as Arbutin, Kojic acid, Ascorbic acid, Dioic acid, Azelaic acid & Phytic acid.

Two products, which are particularly suitable for the management of this condition, are:
1) Lightenex® Gold serum. This is a strongly acidic emulsion containing Glycolic acid, Lactic acid & salicylic acid that dissolves the thick keratin.
In addition, this serum contains high strength Kojic acid, Arbutin, Ascorbic acid, Dioic acid, Azelaic acid & Phytic acid that prevent melanin formation. This serum should be massaged into clean, dry skin every night, two hours before bedtime.
2) Lightenex® Body Lotion. This is a intensely moisturizing day time body lotion containing very high strength Kojic acid & Arbutin but without any acid.
It allows whitening and use in sensitive parts of the body such as the armpits & groins. It should be applied twice daily to the dark patches of skin.

Hydroquinone is the benchmark by which all skin-lightening agents are measured.
One fact that escapes every one is that the Melanocyte is a cell that reacts very badly to irritation or suppression by Hydroquinone, which can damage the cell permanently leaving a visible “Halo”.
Dermatologists often say that they have never seen “Ochronosis” caused to their patients by Hydroquinone.
Unfortunately, this condition is not a “Clinical diagnosis” but a Histological one. Therefore, since the doctors do not routinely do regular biopsies of skin that they are treating, they never diagnose the condition early enough.
Therefore “Ochronosis” is seriously being under diagnosed.
Asians & darker skinned people develop patches of hyperpigmentation easily because they are genetically endowed with large Melanocytes.
They also very often develop “Rebound hyperpigmentation” after stopping the hydroquinone.
Addiction to hydroquinone is also a growing problem, leading to permanently damaged skins that do not respond to any treatment.
Because of these reasons, it is safer to use a combination of high strength skin lighteners known to be effective.
Proven ingredients include Kojic acid, Arbutin, Phytic acid, Azelaic acid, Vitamin C esters, Dioic acid, Nicinamide, Retinoids, Alpha hydroxyl acids, Licorice.
Unfortunately, most companies using these ingredients do not use them in high enough concentrations to lighten the skin.
Two products that do contain these ingredients in optimal concentrations are Lightenex® Plus cream & Lightenex® Gold cream use for treating Hyperpigmentation. (www.Pharmaclinix.com)

The best cream for dark circles under eyes must address both the causes of dark under eye circles.

These two are
1) Vascular leakage
Red blood cells containing haemoglobin leak out of capillaries in the skin around the eyes.
This then breakdown to grey-brown haemosiderin, causing the under-eye circles.
These capillaries become leaky due to sugar combining with the protein of the capillary walls to cause inflammation. These inflammatory molecules are called Advanced Glycation end products (AGEs). Chronic mouth breathers due to nasal blockage (allergy or rhinitis) can exacerbate this capillary leakage, as the blood drains from around the eyes, through the nose and nasal blockage will cause back pressure .

2) Melanin overproduction
There is overproduction of melanin again due to inflammation or when any skin irritation leads to chronic eye rubbing.

Listed below are some of the best vascular restorers that work to stop capillary leaks:

Vascular Restorers & Dermal Strengtheners.

1. Albia julibrissin extract
• Restore skin protein elasticity
• Prevents blood-vessel leaking
2. Palmitoyl tripeptide-38
• Increase Collagen
• Increase Fibronectin
• Increase Hyaluronic acid
• Reverses under eye bags.
3. Green Tea Extract
• Anti-oxidant reversing free radical damage
4. Caffeine
• Constricts small vessels
• Reduces Inflammation.
The best Skin whiteners for around the eyes are:
• Arbutin & Harounoside
• Xanthohumol
• Di-acetyl boldine
• Glabridin (Liqorice extract)
• Sodium ascorbyl phosphate
The only product designed with all the above as well as sun protection factor spf15 is Eyerix® cream by Pharmaclinix®, that will carry out both the actions of an excellent dark circles and bags under the eyes.

“Skin lightening cream” is an over-simplification that can be misleading.
The number of people trying to lighten their skins is far less than the numbers that are trying to rid themselves of dark, patchy skin to give an even brighter skin tone.

The pigment that gives an individual their skin colour is called Melanin.
People have a basal level of melanin production, which gives them their skin tone or colour.
However, due to the stimulation of the sun, hormones, infection or inflammation greater amounts of this pigment is produced, called Hyperpigmentation.
Regardless of the cause or type of hyperpigmentation, a skin lightening cream works by one of two methods:
• Reduce Melanin production: The clinically proven agents to do this include Alpha Arbutin, Beta Arbutin, Kojic acid, Vitamin C, Dioic acids e.g. Azelaic acid & Octadecenedioic acid, Phytic acid, Mandelic acid, Ferrulic acid , Niacinamide, Licorice extract, N acetyl glucosamine.
• Remove Melanin: These include acid exfoliators e.g. Fruit acids such as glycolic acid, citric acid, Lactic acid.
Another group of non-acid exfoliants include Retinoids which are analogues of vitamin A, including Retinyl Palmitate, Retinol, Retinaldehyde & Retinoic acid.

It is important for buyers to be aware that the above ingredients are established skin lighteners with the greatest scientific research to support it.
There are other issues to consider while choosing a product.
Do you have sensitive skin?
If so, do not use products containing fruit acids.
A perfect powerful cream without fruit acids is Lightenex® Gold cream.

If you have oily resistant skin, then the fruit acids are necessary to allow penetration of the skin lighteners into skin e.g. Lightenex® Gold serum with glycolic acid.

Therefore, there can never be one skin lightening cream that will be safe and effective on all skin types.

In addition, if the skin pigmentation is superficial e.g. freckles, it is unnecessary to use fruit acids, then, Lightenex® Plus cream should do the job without over- irritating the skin.
If a dry sensitive skin requires a skin lightening cream, then Lightenex® cream is excellent .

“Face exfoliator” is a general term for any procedure that increases the removal of epidermal cells i.e. the top layer of skin.
The rationale is that removal of these cells will promote the generation of new keratinocytes, which will hopefully give a smooth topography and reduced melanin carrying cells.

There are three mechanisms of action of a face exfoliator:
1)Mechanical: Here a particle is rubbed into the skin to loosen the dead surface keratin of skin. Unfortunately, most products use apricot or other fruit kernels which are crushed to small sizes. These have a disadvantage in that they tend to have sharp, jagged edges that tear the skin surface unevenly, leaving sore areas of the face especially, the thin skin of the cheeks and upper lip.
The best solution is to use a bead-based products because they are perfectly smooth spheres that remove the skin keratin without tearing the skin.

2)Acids: These are usually fruit acids such a Glycolic acid, citric acid etc. that chemically dissolve the keratin on skin. These are again very effective in removing dead surface cells but cannot be used on a daily basis to cleanse & exfoliate the skin, as irritation can develop easily especially in dark skin tones.

3)Enzymes: Papain and Bromelain are excellent exfoliators that use natural keratin-dissolving catalysts to help exfoliation.
They can be used on a daily basis without irritation.

The optimum combination for safe and effective daily cleansing & exfoliation needs the following ingredients

Skin Whiteners:
• Arctostaphylos Uva Ursi (arbutin)
• Mitracarpus Scaber extract
• Niacinaminde
Enzymatic Peeling agents
• Papain
• Bromelain

Skin Conditioners
• Propylene Glycol
• Schizandra Chinesis extract
• Mannitol
• Solanum

Surfactant/Cleansers
• Sodium Laureth Sulfate
• Magnesium Laureth Sulphate
• Sodium Laureth-8-sulphate
• Magnesium Laureth-8-sulphate
• Sodium Oleth Sulphate
• Magnesium Oleth Sulphate
• Cocomidopropyl Betaine

Antioxidants
• Lycopersicum extract
Lightenex® Face Scrub is designed with the above ingredients to give maximum safe exfoliation with whitening beads.

This is a common problem in dark skinned people, where the skin tone in the groin & armpits is darker than the surrounding areas.

There are three main reasons for this:
Friction-The skin in these areas is rubbing against each other, setting up irritation & inflammation, leading to melanin overproduction.
Infection-Fungal infection in these sweaty areas is quite common & can present with itchy dark patches.
Familial-This dark skin problem runs in families. This is, by far the most common cause.

Once infection is excluded, it is important to check if the skin is thickened in the groin or armpits before treatment is advised.
If the skin is thickened or velvety in nature, then it is likely to be a condition called Acanthosis Nigricans, which is a common problem in dark-skinned people.
(Management of Acanthosis nigricans is discussed separately in another article.)
If the skin is of normal thickness, then the management should include:
1) A night time exfoliant/skin whitening compound formulation including ingredients such as Glycolic acid, Retinaldehyde, Lactic acid, salicylic acid with skin lighteners Kojic acid, Arbutin, Dioic acid, Azelaic acid, Phytic acid & Vitamin C.
An exceptional formulation called Lightenex® Gold Serum, by Pharmaclinix® contains the above ingredients in sufficient concentration to remove skin cells, as well as reduce melanin formation.
This serum should be massaged into clean dry skin of the groin & armpits on alternate nights.
This is important as Lightenex® Gold serum is a very strong serum & the skin in these parts is usually sensitive and can become irritated if used on a daily basis.
The frequency of application can then be increased by one night every week, so that it is being massaged into skin every night, by week five of use.
Lightenex® Gold Serum does tend to dry the skin & a deeply moisturizing & whitening lotion is necessary to prevent irritation.

2)Lightenex® Body Lotion is a soothing moisturizer with 36% skin whiteners that continue to prevent new melanin formation during the day. This should be massaged into clean dry skin twice daily.
A good reduction in skin darkening should be expected within six weeks.

3)An alternative is to have a chemical peel procedure performed using a Mandelic acid-based peel with skin whiteners. Lightenex® Max Peel is such a peel, which is available at “The Hyperpigmentation Clinic,12 Harley Street, London” (www.Hyperpigmentationclinic.com) where the outcomes are more rapid.

There are two main reasons for failure to lighten the skin with skin lighteners.

1.
PRODUCT FAILURE-This is a major reason for failure.
Although most products are aesthetically acceptable, a major cause of failure is that ingredients with very dubious evidence are being used.
In addition, if established ingredients are used, they are in too a low concentration to be effective.
A good example is Magnesium Ascorbyl Phosphate (MAP).
Now MAP has been found to be effective at 10% concentration only.
However, because of the cost or stability issues, most companies use a much lower, undeclared concentration which, although appears on the ingredient list of the product, fails to work.
The only product for skin lightening with a declared concentration of 10% MAP is Lightenex® Gold cream by Pharmaclinix®.
Therefore a product that fails to tell you the concentration of each ingredient they use usually has something to hide.

2.
USER FAILURE-Most people using skin lighteners do not understand that sun protection, along with sun avoidance behaviour is necessary to get effective skin lightening.
This applies more to dark skins because they have large, active pigment producing cells, called Melanocytes that easily react to UV light from the sun.
This sun protection cream should be of sun protection factor (SPF) 50 & a thick layer should be applied at least three times daily.
This should also be done while indoors or on dull days.
Sun blocking is even more mandatory if using the oral contraceptive pill or Hormone replacement therapy after menopause.
Even the Infra red or heat from a cooker can activate the melanocytes.
The only problem with sun blocks is that the best physical sun blockers such as Titanium dioxide or Zinc oxide leave a grey sheen colour on skin.
This problem can be mitigated by using micronized titanium dioxide which although expensive, is aesthetically more acceptable.
Sun Blockex® SPF 50 by Pharmaclinix, is such a product and allows one to walk confidently when wearing it.

Clinically, the best results for skin lightening have been found by using Lightenex® Gold cream, followed by Sun Blockex® SPF 50.

This is a poorly understood condition that plagues many people with dark skin tones. There are two main reasons that contribute to this condition.
1) The epidermis under the eyes i.e. the top layer of skin, is very thin. This allows any dark pigmentation in the skin or wrinkles to look more pronounced & worse.
2) The capillaries in the dermis have a tendency to leak easily, allowing red blood cells to leave the blood vessels and deposit in the tissue. The haemoglobin in these red blood cells breaks down to a dark brown-blue pigment called Haemosiderin. This is the cause of the colour of dark circles.
The main reason for these leaky capillaries is Advanced Glycation End products (AGEs).These AGEs are generated when the protein lining the capillaries combines with glucose to create an inflammatory molecule, causing them to leak blood into the tissues.
Therefore any product used to treat this difficult condition must contain Anti AGEs ingredients to address this problem.
In addition, a sun protection factor of at least 15 should be present. Blood vessel vasoconstrictors, such as caffeine is also very good.
One product that meets these requirements is Eyerix® that contains depigmenters+Anti AGEs+spf15.