Journal of Clinical and Aesthetic Dermatology

FEB 2018

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

Issue link: http://jcadonline.epubxp.com/i/934167

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31 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY February 2018 • Volume 11 • Number 2 R E V I E W TABLE 1, continued. Summary of clinical studies evaluating the efficacy of natural ingredients as hypopigmenting agents NATURAL INGREDIENTS STUDY HYPOPIGMENTING MECHANISM COMPARISON PIGMENTATION DISORDER CONCLUSION LEVEL OF EVIDENCE* ELLAGIC ACID RCT (Ertam et al) 29 Tyrosinase inhibition 1% arbutin vs. synthetic 1% ellagic acid vs. synthetic 1% ellagic acid with plant extracts containing natural ellagic acid Melasma All three treatments show efficacy IB RCT (Dahl et al) 30 0.5% ellagic acid combined with 0.1% salicylic acid vs. 4% HQ Hyperpigmentation and dark spots Based on clinical grading, physical measurement of spot size by Chroma Meter, and patient questionnaire analysis, the compound had comparable efficacy to HQ but better aesthetics IB ARBUTIN RCT (Ertam et al) 32 Tyrosinase inhibition 1% arbutin vs. synthetic 1% ellagic acid vs. synthetic 1% ellagic acid with plant extracts Melasma All three treatments show efficacy IB Single-group efficacy trial (Polnikorn et al) 33 None Melasma 7% alpha arbutin in conjunction with the MedLite C6 Q-switched Nd:YAG laser showed favorable results IIB GREEN TEA RCT (Syed et al) 36 Antioxidant 2% analogue of green tea extract vs. placebo control Melasma 2% analogue of green tea extract in hydrophilic cream shows clinical efficacy IB TURMERIC RCT/split-face (Swanson et al) 38 Antioxidant Turmeric extract cream formulation vs. unknown control Facial hyperpigmentation Formulation improved areas of hyperpigmentation by 14.16% (P<.0001) at four weeks IB SOY Controlled trial (Hermanns, 2000) 52 Anticarcinogenic (Isoflavones), inhibits melanosome transfer to keratinocytes (serine protease inhibitors) Azelaic acid vs. glycolic acid vs. soy extract Facial hypermelanosis Soybean extract showed clinical efficacy based on video camera analysis IIA Controlled trial (Pierard et al) 53 None; authors compared affected vs. unaffected areas Melasma Application of soy extract to melasma lesions once daily for 3 months led to an average reduction of hyperpigmentation of 12% IIA RCT (Wallo et al) 45 Soy moisturizer vs. vehicle control Facial photodamage Application of soy-containing moisturizer improved mottled pigmentation, blotchiness, dullness, fine lines, overall texture, overall skin tone, and overall appearance IB *Level of evidence—IA: evidence from meta-analysis of randomized controlled trials; IB: evidence from at least one randomized controlled trial; IIA: evidence from at least one controlled study without randomization; IIB: evidence from at least one other type of clinical study; Nd:YAG: neodymium-doped yttrium aluminum garnet; RCT: Randomized controlled trial; HQ: hydroquinone

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