Full list of ALL evidence based skin lightening with effectiveness rating. For fixing PIH, melasma AND whitemaxxing.

[LegitUser]

What is this and how to use it:
The table has been taken for a review article comparing the treatments available for the skin conditions in the title.
How to use it:

1. Choose the most effective treatments, by looking at the adverse events collumn and seeing what is within your risk tolerance
2. Do not choose multiple treatments that work via the same mechanism of action, there is no point
3. Cycling tri-luma / TCT / pigmoren and then using treatments from here when you are off TCT cycle will be most effective. TCT = combination of a topical steriod, high strength retinoid, and 4% hydroquinone

Table 2: New Oral and Topical Treatments

Table 2: New Oral and Topical Treatments

Category	Agent	Reference	Mechanism of Action	Dosing	Study Outcomes	Adverse Events
Photoprotection	Topical Iron Oxide Sunscreens	Boukari et al., 2015; Castanedo-Cazares et al., 2014; Duteil et al., 2017; Lakhdar et al., 2007; Mahmoud et al., 2010; Regazzetti et al., 2018	Blocks blue visible light	SPF ≥ 50	UV-visible light regimen had significant improvement	None
	Oral Polypodium leucotomos	Goh et al., 2018; Martin et al., 2013; Nestor et al., 2014; Siscovick et al., 2008	Promotion of p53 suppressor gene expression; modulation of inflammatory cytokines; ↑ endogenous antioxidant systems; blockade of UV radiation induced cyclooxygenase-2 expression	240 mg BID	Beneficial effect; Greater reduction in MASI	Mild gastrointestinal upsets
Lightening Agents	Oral and Topical Tranexamic Acid	Banihashemi et al., 2015; Del Rosario et al., 2018; Ebrahimi and Naeini, 2014; George, 2016; Kim et al., 2016; Lee et al., 2016; Lee et al., 2017; Na et al., 2013; Perper et al., 2017; Taraz et al., 2017; Wu et al., 2012	Blocks conversion of plasminogen to plasmin; Blocks binding of plasminogen to keratinocytes; ↓ arachidonic acid release, prostaglandin synthesis, and FGF; ↓ melanin synthesis; ↓ mast cells; ↓ angiogenesis	2-5% BID (topical); 250 mg BID (oral)	Global studies document significant reduction in MASI score	Oral: mild gastrointestinal discomfort, hypomenorrhea, allergic skin rashes, alopecia, and mild elevations in alanine transaminase; Topical: erythema, scaling, dryness; Propensity to induce thromboembolic phenomena
	Melatonin	Hamadi et al., 2009; Ryoo et al., 2001	Potent antioxidant/free radical scavenger; ↑ superoxide dismutase, glutathione reductase, glutathione peroxidase; ↓ α-MSH receptors	5% BID (topical); 3 mg daily (oral)	Decreased MASI; malondialdehyde decreased; GSH levels increased	Not reported
	GSH	Handog et al., 2016; Sonthalia et al., 2016; Watanabe et al., 2014	Decreases tyrosinase; skews conversion of eumelanin to pheomelanin	2% daily (topical); 500 mg daily (oral)	Melanin index significantly reduced	Intravenous: Stevens-Johnson Syndrome, anaphylaxis; Oral and topical: none
Topical	Cysteamine	Besouw et al., 2013; Mansouri et al., 2015	Radioprotector (via direct scavenging effects of hydroxy radicals); Tyrosinase peroxidase inhibition	5% daily	Reduced MASI compared to placebo	None reported
	Pigment-correcting Serum	Makino et al., 2016	Melanocyte activation, melanosome development, melanin synthesis, melanosome transfer; keratinocyte differentiation and desquamation		Comparable efficacy to hydroquinone	Mild irritation
	Methimazole	Kasraee et al., 2005; Kasraee et al., 2008	Potent peroxidase inhibitor; blocks melanin synthesis	5% daily	No significant changes in serum TSH, free thyroxine, free triiodothyronine levels	Minimal cutaneous side effects
	Flutamide	Adalatkhah et al., 2011	Blocks action of endogenous/exogenous testosterone by binding to androgen receptor	1% daily	MASI/colorimetry effects similar to hydroquinone 4%; Patient satisfaction scores significantly high	None

BID: twice daily; FGF: fibroblast growth factor; GSH: glutathione; MASI: Melasma Area Severity Index; MSH: melanocyte-stimulating hormone; SPF: sun protection factor; TSH: thyroid-stimulating hormone; UV: ultraviolet


Table 1: Current established treatments

Name	Mechanism of action	Side effects	Reference
Hydroquinone	Tyrosinase inhibition	Erythema, irritation, exogenous ochronosis	De Caprio, 1999, Grimes, 2009, Nordlund et al., 2006, Tse, 2010
Azelaic acid	Tyrosinase inhibition	Stinging, burning, itching, dryness	Hashim et al., 2018, Schulte et al., 2015
Kojic acid	Tyrosinase inhibition	Irritation, contact dermatitis	Deo et al., 2013, Lajis et al., 2012, Monteiro et al., 2013
Ascorbic acid	Inhibition of reactive oxygen species	No significant adverse event	Al-Niaimi and Chiang, 2017, Pires et al., 2018
Retinoids	Downregulation of Tyrosinase	Irritant reaction, dryness, hyperpigmentation	Kang, 2005
Corticosteroid treatments	Antiinflammatory and nonselective inhibition of melanogenesis	Telangiectasias, epidermal atrophy, steroid-induced acne, striae, hypopigmentation	Menter, 2004
Niacinamide	Inhibition of melanasome transfer	Irritation	Bissett, 2002, Navarrete-Solís et al., 2011, Wohlrab and Kreft, 2014
Licorice	Melanin dispersion, tyrosinase inhibition	No significant adverse event	Picardo and Carrera, 2007; Videira et al., 2013
Undecylenoyl phenylalanine	Antagonist of α-melanocyte-stimulating hormone, β-adrenergic, stem cell receptors	No significant adverse event	Glowka et al., 2018, Olejnik et al., 2018
4-N-butylresorcinol	Tyrosinase inhibition, antioxidant, antiinflammatory	Mild erythema and itching	Huh et al., 2010; Wargniez et al., 2017
Soybean	Inhibits melanosome transfer to keratinocytes	No significant adverse event	Birk, 1985, Paine et al., 2001
Arbutin	Inhibition of tyrosinase	Skin irritation	Sarma et al., 2017
Glucosamine	Inhibition of tyrosinase activation	Skin rash	Niwano et al., 2018
Mequinol	Inhibition of tyrosinase	Skin irritation, redness, peeling	Keeling et al., 2008

 

[baku9]

why is there a tranny drug (flutamide) there

 

[LegitUser]

why is there a tranny drug (flutamide) there

cuz it works
also how did you know so quickly it was a tranny drug. do you have something you want to share?

 

[Thebuffdon]

High iq and well documented. Bump

 

[baku9]

cuz it works
also how did you know so quickly it was a tranny drug. do you have something you want to share?

i was researching anti androgens for hairloss when i saw flutamide...very unsafe for mens virility