Understanding Hyperpigmentation and the Ingredients that Target it

What Causes Hyperpigmentation?

Hyperpigmentation occurs when excess melanin forms deposits in the skin, creating darker patches. This can result from sun exposure, inflammation, hormonal changes, or genetic factors. Your prescriber identifies the cause, which guides the choice of treatment.

Types of Hyperpigmentation

Common forms of hyperpigmentation include:

Melasma: Typically hormone-related, appearing as symmetrical patches on the face
Post-inflammatory hyperpigmentation: Occurs after skin inflammation from acne, eczema, or injury
Solar lentigines: Sun spots that develop from cumulative UV exposure
Freckles: Small, concentrated melanin deposits, often genetic and triggered by sun exposure

Ingredients Prescribers Use for Hyperpigmentation

These are ingredients a prescriber may write in a compounded formula. We prepare the formula on the prescription.

Hydroquinone

The most-studied prescription depigmenting agent, hydroquinone works by inhibiting tyrosinase, the enzyme responsible for melanin production. Your prescriber sets the strength and how long to use it. Prescribers often limit hydroquinone to set periods.

Kojic Acid

This natural byproduct of fermented rice works as a tyrosinase inhibitor and antioxidant. Prescribers sometimes combine it with other brightening ingredients.

Tranexamic Acid

Originally used to reduce bleeding, tranexamic acid inhibits plasmin, which plays a role in melanin synthesis. Prescribers use it topically for melasma, off-label.

Vitamin C Derivatives

Stabilized forms of vitamin C, such as tetrahexyldecyl ascorbate and magnesium ascorbyl phosphate, are more stable in a formula than pure ascorbic acid. Vitamin C is an antioxidant.

Alpha Arbutin

Alpha arbutin is a tyrosinase inhibitor related to hydroquinone. Some prescribers use it when hydroquinone is not a fit.

Customized Combination Approaches

Prescribers often combine several active ingredients for hyperpigmentation. Our pharmacists compound the formula your prescriber writes, at the concentrations on the prescription.

Ingredient	How it works	Notes
Hydroquinone	Tyrosinase inhibitor	Prescription; prescriber sets strength and duration
Kojic Acid	Tyrosinase inhibitor, antioxidant	Can irritate some skin
Tranexamic Acid	Plasmin inhibitor	Topical use is off-label
Alpha Arbutin	Tyrosinase inhibitor	Related to hydroquinone
Vitamin C	Antioxidant	Stability depends on the form used

The Importance of Sun Protection

Any hyperpigmentation treatment must be accompanied by diligent sun protection. Ask your prescriber about daily broad-spectrum sunscreen. The American Academy of Dermatology advises SPF 30 or higher.

When to Seek Professional Help

If you have persistent hyperpigmentation, talk with your dermatologist. If they prescribe a compounded formula, they can send it to us and we will prepare it as written.