5 Things You Can Do to Have Healthy Skin in the COVID-19 Circuit Breaker

The recent COVID-19 Circuit Breaker means that a lot of us have now either brought our work home, or are on a period of extended leave. It also means that we are now not able to go for our routine facials and skin treatments. 

How can we keep our skins looking healthy and not look like we aged a decade when we complete this month-long social segregation?

Below we share five things we can do to keep our skins supple and healthy in this period. 

1. Hydration

Now that we are stuck at home, whether working or not, “having no time” is no longer an excuse for skipping or forgetting that all important H2O that we too often have no time for. Water is one of the most important liquid to drink as it acts as a transporter and is also an important substrate in many of our body processes.

For our skin, water keeps it hydrated and youthful looking by filling and plumping up the hyaluronic acid molecules bounded within the collagen fibres in our skin. It can also improve complexion and early fine line and dull skin.

It can also help weight loss by replacing our modern day calorific rich drinks such as sodas, sweetened coffees etc. 

2. Balanced Diets

Being asked to stay at home does not mean we can relax on our diets. In fact, it may be a good time to assess our diets and ask ourselves if we are eating as healthy as we ought to be. With the decreased energy expenditure now that we are not commuting daily to work, or for those of us who have a job scope that is more physically active, now that our days are more sedentary, it is important that we try to cut out as much as possible refined and processed foods.

Swap a meal for a healthy salad, or do that home cookout instead of reaching over to your phone for the next takeout meal. These will allow us to incorporate into our diets more antioxidant-rich foods that have been proven to push back ageing while removing the refined, processed and sugary ones that are now known to add years onto our skin and health. 

3. Exercise

Now that we have time to plan our day out, including an exercise session at least 3 times a week can help not just our health, but also our skin. Exercise is great for the body and mind, and can also do wonders for our complexion.

Sweating can help flush out toxins from our pores. Do be aware to wash after a session, as leaving sweat, dirt and sebum on your skin can cause breakouts and sensitivity. By working out, we can also maintain healthy levels of the stress hormone cortisol and help stimulate collagen production to keep our skin firm and supple.

Improving muscle tone can also make our skin look firmer and reduce the appearance of cellulite. There is also the post-workout glow which happens when our skin receives a good dose of oxygenated blood and our skin starts producing its natural oils. 

4. Get Sufficient Rest and Sleep

One of the things most of us loathe on a workday is needing to sleep late and wake up early. There is now little excuse to deprive our bodies of its much-needed sleep. Benefits of sleep for skin include fewer wrinkles, less sagging, rejuvenated colour, fewer acne blemishes and less inflammation. The reasons for these are many, but some of them are because the skin repairs itself at night.

During this overnight process, our skin builds collagen, elastin and hyaluronic acid, all of it responsible for our skin’s plumpness, translucency and elasticity. Getting sufficient sleep also boosts our immune system and reduces the stress hormone cortisol which then reduces our propensity to developing acne and inflammation.

Increased blood flow during sleep into our facial area also helps remove free radicals and pollutants accumulated throughout the day and helps repair any damage incurred and restore our complexions to a radiant colourful glow.

5. Overhauling Our Skincare Regimen

Now that we are deprived of our weekly/fortnightly facials, we need a skincare regimen that can continue to target our active skin issues whilst protecting us against oxidative stressors and ageing. How do we go about this? 

a) Select your skincare products based on your skin type and lifestyle, e.g. cleansers should not only suit your skin type, but also be sufficient in removing the type and amount of makeup that you use, or in removing any type of occupational exposures. Foaming liquids are generally suitable for people with oily or acne-prone skin, whilst micellar water are more suitable for individuals with normal skin. Mature skin may require cleansers that are more moisturizing such as a melting balm or cream-based cleanser.

b) Gone are the days of toners being an alcohol-based product used for drying up oily skin and removing any leftover dirt after cleansing. In the modern day regimen, toners are a good way to add in specific ingredients that you may not have in your other products. These can be alpha and beta hydroxy acids, hyaluronic acids, vitamins or even simple things such as rose water. They should be done after cleansing, before putting on anything else.

c. Serums are powerful skin allies which we can use to address specific issues, such as pigmentation, dark spots or wrinkles. These are usually applied after your toners but before moisturizers. Some ingredients to look out for are hyaluronic acid to seal in moisture, vitamin C to brighten dull skin and decrease dark spots, retinol, vitamin B3 and peptides for anti-ageing.

d. Moisturizers should like cleansers, be selected based on your skin type and lifestyle. Everyone needs moisture but the texture of your moisturizer will differ based on your skin type. What a moisturizer should provide however is to protect your skin from environmental aggressors and replenish moisture levels.

e. Protecting your skin with a sunscreen. It goes without saying that sunscreen is hands down the most crucial skincare product. Daily and consistent use of sunscreen helps to prevent the development of fine lines and wrinkles, textural imperfections and changes in the appearance of pores over time.

With these, we hope that you are now better equipped to deal with the different set of challenges that the COVID-19 Circuit Breaker throws our skin. Let us all be consistent, and take good care of our health, well-being and skin during this difficult period. 

Hydroquinone is one of the most famous whitening agents. It is most studied to date, and very effective. However, it does have some serious side effects, can be irritating to skin and has been heavily restricted in some countries. 

Today, we look at some of the other whitening agents on the market, how they work and what side effects they have. 


HOW DO SKIN WHITENING AGENTS WORK?

Whitening agents in the market work in a number of different ways, some in more than one way. But most will generally slow down the production of melanin, which is what gives our skin it’s colour and tone.

The agents available on the market generally work by acting on the first step of melanin synthesis – the conversion of tyrosine into DOPA and dopaquinone by an enzyme called tyrosinase. They work by either:

  • Acting as a mimic of tyrosine – essentially keeping tyrosinase too busy to produce as much melanin as before (hydroquinone, mequinol, azelaic acid, arbutin, licorice extract) 
  • Blocking off important copper ions in tyrosinase and thus preventing the enzyme from working (kojic acid) 

There are also other ingredients that can reverse or slow down hyperpigmentation using other pathways: 

  • Slowing down production of the tyrosinase enzyme (N-acetylglucosamine)
  • Reversing the reaction that tyrosinase does (ascorbic acid/Vitamin C)
  • Slowing down maturation of melanosomes (arbutin and derivatives)
  • Preventing melanin from travelling from melanocytes to skin cells (soy, niacinamide, retinoids)
  • Dispersing pigments (licorice extract)
  • Increasing skin turnover, meaning less pigments to go around (alpha and beta hydroxy acids, retinoids) 

There are also other ingredients that can reverse or slow down hyperpigmentation using other pathways:

In general, side effects are less of a concern for less effective ingredients, but combining different agents may result in a more potent product without too much irritation. 

Below, we investigate the agents individually: 

1. Mequinol

Mequinol is the main alternative prescription alternative to hydroquinone. It is not entirely clear how mequinol works, but it seems similar to hydroquinone in that it mimics tyrosine and decreases tyrosinase’s ability to produce melanin. It comes in concentrations of 2% and sometimes in combination with 0.01% tretinoin and ascorbic acid to enhance penetration.

It is supposed to be less irritating than hydroquinone but can sometimes cause temporary postinflammatory hyperpigmentation (PIH). Rarely, it can lead to reversible depigmentation. 

2. Retinoids

Retinoids are Vitamin A analogues used for treating many conditions such as acne, sun damage as well as acting as a penetration enhancer for other treatments. Examples are: tretinoin, adapalene, tazarotene, isotretinoin (prescription) and retinol (non-prescription).

Retinoids are thought to work in multiple pathways to reduce pigmentation, including increased skin turnover, interruption of melanin transfer to skin cells, reduced tyrosinase production in skin and dispersal of melanin. Retinoids are commonly used in combination with other treatments for hyperpigmentation as on their own, they can take several months to achieve results.

In general, the more effective a retinoid is, the more irritating its side effects. Common side effects include redness, dryness and peeling. PIH is also a risk, especially in darker skin. 

3. Azelaic Acid

Azelaic acid is another common alternative to hydroquinone. It is produced by a fungus which sometimes infects humans and causes light patches of skin. It is slightly milder than hydroquinone but in combination with retinoids, can come close to the effects of hydroquinone.

Azelaic acid works by interfering with tyrosinase activity as a tyrosine mimic, and suppresses and kills abnormal melanocytes. It is known for its lack of side effects, which are mild stinging and redness. 

4. Arbutin

Arbutin is sometimes also known as the “natural hydroquinone”. Its chemical structure is very similar to hydroquinone. It is found in extracts of bearberry leaves and to a lesser extent in cranberry and blueberry leaves.

It works in our bodies by slowly turning into hydroquinone and acting as a tyrosine mimic to slow down production of melanin. It also interferes with maturation of melanosomes. Results from studies on its efficacy are mixed.

The most common formulation is 5% although there are higher formulations. Higher concentrations of arbutin increase the risks of PIH. 

5. Kojic Acid

Kojic acid is produced by bacteria in the fermentation of rice in the manufacture of Sake.

A derivative of kojic acid, kojyl-APPA has also been investigated on its whitening effect and improved skin penetration. It works by binding to copper in tyrosinase, preventing the enzyme from performing its role in the production of melanin.

It is often combined with hydroquinone, retinoids, glycolic acid, emblica extract or corticosteroid. It is very irritating and is a potential allergen. Preparations typically include steroids to reduce the chances of a reaction. 

6. Licorice Extract

Licorice extract is extracted from the root of the licorice plant (Glycyrrhiza glabra) and is widely used as a whitening ingredient in cosmetics. It contains a number of antioxidants and anti-inflammatory chemicals. Its main effects are through two whitening components, glabridin and liquirtin.

Glabridin protects skin from UV-B induced pigmentation whilst also acting on tyrosinase to slow down melanin production. Liquirtin disperses melanin. Licorice extracts are mild and have few side effects, likely due to its anti-infammatory and anti-irritant ingredients. 

7. Ascorbic Acid (Vitamin C)

Vitamin C is an ingredient in many skincare products. It is a potent antioxidant, but is very unstable and is usually combined with other ingredients.

Vitamin C works by turning dopaquinone back into L-DOPA, undoing the reaction that tyrosinase does. It is less irritating than hydroquinone and has an excellent safety profile. 

8. N-Acetylglucosamine

N-acetylglucosamine is a sugar found abundantly in nature and is a precursor of hyaluronic acid. It works by slowing down the production of tyrosinase, which is a crucial enzyme in the synthesis of melanin.

It has been found to improve pigmentation at 2% in clinical studies and is often used in conjunction with niacinamide. It can cause mild to moderate skin irritation occasionally. 

9. Niacinamide

Niacinamide is also known as nicotinamide and Vitamin B3. It is an antioxidant but unlike vitamin C, it is very stable. It works by inhibiting the transfer of pigments to skin cells. 2-5% is the typical concentration and has been found to be effective in reducing hyperpigmentation in several studies. Some skin irritation can occur. 

10. Cysteamine

Cysteamine is a new kid on the block when it comes to pigments. It is a chemical compound that can be biosynthesized in mammals (this includes humans) by degradation of co-enzyme A. It was conventionally used as a treatment for cystinosis.

Recently, ScientisPharma had compounded it into a 5% cream for treatment of hyperpigmentation and to lighten skin overall. Cysteamine is a metabolite of L-cysteine which inhibits melanin synthesis. The ways it is thought to work through includes inhibition of tyrosinase and peroxidase, scavenging of dopaquinone, chelation of iron and copper ions and increasing intracellular glutathione.

Randomized controlled trials have confirmed the efficacy of cysteamine cream in treatment of epidermal melasma, a hyperpigmentation disorder. Side effects are generally mild, with temporary heating up or burning sensation and redness that is typically short-lived. 

In Conclusion

That is 10 alternatives to hydroquinone for hyperpigmentary disorders, all with different modes of action. If you are wary of hydroquinone, or your skin cannot handle it, there are still plenty of options for treatment of hyperpigmentation. Feel free to speak to your doctor if you have concerns with hydroquinone or if there is pigmentation on your face that you are concerned about.