Best Treatments For Dark Spots (Hydroquinone Alternatives)


What’s the best treatments for dark spots on the face (or anywhere else, really)?

Hydroquinone is the gold standard your derm recommends for dark spots, melasma and all kinds of hyperpigmentation. But, no one wants to use it anymore.

It’s got its fair share of blame, though. It’s harsh like hell. It’ll take your dark spots away and leave you with irritated skin (no, not cancer – that’s just a rumour).

No wonder we’re all looking for alternatives! There are aplenty. From retinoids to azelaic acid and arbutin, these days we’re spoiled for choice.

But, how to pick the right one for you? Here’s the lowdown on the most common skin-lighteners used in skincare and how they compare to hydroquinone, so you can choose the best treatment for dark spots for your unique skin type and needs:

What Causes Dark Spots On The Face?

Dark spots on your face (or anywhere else, really) are the result of an overproduction of melanin. This can happen for several reasons:

  • Hormonal changes: Changes in hormones, especially during pregnancy, can cause Melasma.
  • Post-inflammatory hyperpigmentation: Skin injuries, acne, psoriasis, and eczema are all inflammatory conditions that can increase pigment in the skin and lead to dark spots. The most common type is the discolourations pimples sometime leave behind after they heal.
  • Medication side effects: Chemotherapy drugs, antimalarials, anticonvulsants, and even some anti-inflammatory drugs can all lead to dark spots.
  • Sun damage: UV rays generate free radicals that cause inflammation that increasing the production of melanin, leading to dark spots. These dark spots form years afterwards, usually from your 40s. The more unprotected sun exposure you get, the sooner these darks pots form.

How To Treat Dark Spots

Now you know what causes dark spots on your face and body, let’s talk treatments. There are a gazillion treatments for dark spots – and they all involve reducing the production of melanin.

Melanin is the pigment that gives your skin its beautiful, natural colour. But when some cells go into overdrive and produce more melanin compare to its neighbours, you get a dark spot here and there. You want a treatment that reduces the overdrive and lets your cells produce their normal amount of melanin.

Which treatments work best? Here’s the catch: everyone’s skin is different, so you won’t know what works best for you until you try it. I have clients who love Azelaic Acid and others who swear by Alpha Arbutin. For some, just Glycolic Acid or a high concentration of Vitamin C is enough.

My goal is to introduce you to the most common, best treatments for dark spots, so you can pick the one that’ll suit you best. Clear? Good.

How Long Does It Take A Dark Spot Treatment To Work?

It’s one thing to say to try another treatment for dark spots if the one you picked isn’t working. But how do you know it’s not working? If you only give it a few days, you may be throwing away a gem. Yep, it takes more than a few days to fade away dark spots.

As a rule, you need to wait at least 30 days to see some results. Let’s be clear. Your dark spots won’t completely fade away in 30 days. But they should be lighter. If they’re not, or if the improvement is minimal, it’s time to try another dark spot treatment.

Best Treatment For Dark Spots

These are the most common treatments for dark spots available OTC today – in no particular order.

1. Hydroquinone

WHAT IT IS

Hydroquinone is a skin-lightener that occurs naturally in fruits, coffee and beer. It’s considered the gold standard for getting rid of any dark patches on the skin (hyperpigmentation).

HOW IT WORKS

Hydroquinone inhibits the activity of tyrosinase (the enzyme that controls the synthesis of melanin) and increases the cytotoxicity of melanocytes (cells that produce melanin). In plain English, it stops your skin from producing too much melanin, so your dark spots can fade away and your skin can return to its natural colour.

Hydroquinone is used in 2% in OTC products. In prescription products used under your derm’s supervision, the maximum concentration is 4%.

SIDE EFFECTS

Don’t let internet trolls and the natural brigade scare you. There’s no proof hydroquinone causes cancer. It’s true a study found it can cause cancer in mice. BUT, as Dr Levitt points out in his “The safety of hydroquinone: A dermatologist’s response to the 2006 Federal Register“, hydroquinone increases benign liver tumours in mice but it DECREASES cancerous liver tumours. This suggests that hydroquinone may actually have a protective effect! But in humans? Nah. No proof yet.

Yet, hydroquinone isn’t without side effects. It can cause irritation and, in rare cases, ochronosis (gives skin a bluish tint). Ochronosis is very rare, but more common in people with dark skin.

BEST FOR

Anyone with severe hyperpigmentation (if you have dark skin consult a doctor, first). If you’ve tried everything with no results and you have fair skin, it’s worth a go.

BEST PICKS

  • Obagi Nu-Derm Clear Dark Spot Lightener & Corrector Cream: A 4% hydroquinone cream with Vitamin C to lighten dark spots. It’s available by prescription only. Available at Obagi.

Related: Spotlight on Hydroquinone


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2. Kojic Acid

WHAT IT IS

Kojic Acid is made by bacteria during the fermentation process of rice in the manufacture of sake, the Japanese rice wine.

HOW IT WORKS

Kojic Acid inhibits the activity of tyrosinase, the enzyme that’s responsible for the production of melanin. It basically tells it to stop the overproduction of melanin, so dark spots can fade away faster.

It’s effective at 1-4%, but it’s often used with other skin lighteners, such as retinoids, glycolic acid or hydroquinone.

SIDE EFFECTS

It’s less irritating than hydroquinone, but can still cause irritations and allergies. Do a patch test first.

BEST FOR

Anyone with moderate to severe hyperpigmentation who can’t tolerate hydroquinone but doesn’t have sensitive skin.

BEST PICKS:

  • Neostrata Dark Spot Corrector ($30.00): This dark spot corrector is loaded with skin-lightening ingredients, from Kojic Acid to Vitamin C and glycolic acid (more on them below). Available at Dermstore and Neostrata.

Related: Should You Use Hydroquinone Or Kojic Acid?

3. Arbutin

WHAT IT IS

Arbutin is an extract derived from bearberry leaves. It’s nicknamed “natural hydroquinone” because it has a very similar chemical structure to it. Alpha Arbutin is the most common form found in skincare products.

HOW IT WORKS

Arbutin turns into hydroquinone in the body, inhibiting the production of tyrosinase and interfering with the maturation of melanosomes (organelles involved in melanin production). It basically addresses two of the main causes of dark spots, helping them fade away faster. It’s usually found in skincare products at 2% concentrations, but it’s most effective at 5%.

SIDE EFFECTS

High concentrations can cause post inflammatory hyperpigmentation. Proof that more isn’t always better when it comes to your skin.

BEST FOR

Anyone looking for the benefits of hydroquinone in a less irritating, more natural form.

Best picks:

  • Good Molecules Daily Brightening Serum ($8.00): A simple serum with Arbutin and Hyaluronic Acid to hydrate skin and reduce discolourations. Available at Ulta.
  • The Ordinary Alpha Auburn 2% + HA ($11.50): A no-frills Alpha Arbutin serum with hyaluronic acid to plump up skin while fading away dark spots. Available at Beauty Bay, Boots, Cult Beauty, Look Fantastic, Sephora, SpaceNK, The Ordinary, and Ulta

4. Azelaic Acid

WHAT IT IS

A skin-lightener produced by a fungus, Pityrosporum Ovale. When it infects humans, it lightens patches of skin.

HOW IT WORKS

It inhibits the activity of tyrosinase, the enzyme essential to the production of melanin, so it produces less. It also kills abnormal melanocytes, the cells that got so damaged, they produce way more melanin than needed.

15-20% Azelaic Acid is as effective at 4% hydroquinone (but a lot gentler!). Most products on the market only have around 10%. It’s smaller, but enough to see results.

SIDE EFFECTS

Azelaic Acid is one of the gentlest skin-lighteners available, but can sting and cause redness in people with very sensitive skin.

BEST FOR

Anyone with moderate to severe hyperpigmentation who’s looking for a gentler alternative to hydroquinone. It’s suitable for sensitive skin, too.

BEST PICKS:

  • Facetheory Lumizela A15 Serum (£24.99): This azelaic acid serum is enriched with skin-soothers like green tea and oatmeal to reduce dark spots, redness, rosacea, and irritations. Available at Facetheory
  • Paula’s Choice 10% Azelaic Acid Booster ($36.00): This booster contains both azelaic acid and salicylic acid, an oil-soluble exfoliant that can get inside your pores and unclog them from within. Great at treating acne, you can use it on its own or mix it with your moisturiser. Available at Cult Beauty, Paula’s Choice, Sephora, and SpaceNK
  • The Ordinary Azelaic Acid Suspension 10% (£5.50): This serum has a thick texture that’s not the most pleasant to use. But if you’re on a strict budget and want to try azelaic acid, it’ll do the anti-acne and skin-brightening jobs. Available at Beauty Bay, Boots, Cult Beauty, Look Fantastic, SpaceNK, The Ordinary, and Ulta

Related: Paula’s Choice 10% Azelaic Acid Booster Vs The Ordinary Azelaic Acid Suspension 10%: Which One Is Better?

paula's choice 10% niacinamide booster 01

5. Niacinamide

WHAT IT IS

Niacinamide is a form of vitamin B3 (also nicknamed nicotinamide) naturally found in many plants.

HOW IT WORKS

When it comes to treating dark spots, niacinamide inhibits the transfer of pigment to the skin, so dark spots can’t form. At 4-5% concentrations, it’s a good alternative to hydroquinone. It is often used together with other skin-lighteners.

Niacinamide alone won’t fade your dark spots away very quickly, but this is one skin-lighteners you can use together with Azelaic acid, Arbutin, or kojic acid without side effects. Plus, it does a lot of other things for your skin. It moisturises dry skin, treats acne, soothes irritations, and helps fight wrinkles.

I don’t currently have dark spots, but niacinamide is a must in my skincare routine.

SIDE EFFECTS

In rare cases, niacinamide causes flushing. If that’s you, stop using it. Everyone else, you can use it safely.

BEST FOR

Anyone with moderate hyperpigmentation looking for a gentler alternative to hydroquinone. But honestly, unless it makes you flush, you need this in your skincare routine.

Best picks:

  • Paula’s Choice Resist 10% Niacinamide Booster ($42.00): It shrinks your pores, hydrates your skin, and brightens the complexion. Plus, it’s full of antioxidants (including Vitamin C) to help you keep those pesky premature wrinkles at bay, too. Available at Cult BeautyDermstorePaula’s ChoiceSephora, and SpaceNK
  • The Inkey List Niacinamide ($6.99): On top of hydrating niacinamide, it also has hyaluronic acid to add moisture back into the skin and Squalane to strengthen its protective barrier. Plus, it brightens skin and helps prevent wrinkles. Available at BootsCult BeautyThe Inkey List
  • The Ordinary Niacinamide 10% + Zinc 1% (£5.00): Suitable only for oily skin, it reduces excess oil, helps treat acne, and reduces redness and inflammation. Available at Beauty BayBootsCult BeautySephoraSpaceNKThe Ordinary, and Ulta

Related: Spotlight On Niacinamide

the-ordinary-advanced-retinoid-2

6. Retinoids

WHAT IT IS 

Retinoids are forms of vitamin A that can treat hyperpigmentation, wrinkles and acne. OTC examples include retinol and retinaldehyde while prescription forms include tretinoin, isotretinoin and adapalene.

HOW IT WORKS:

Retinoids are multitaskers that fade away dark spots in three different ways. They speed up cellular turnover (the skin’s natural exfoliating process), reduce the amount of tyrosinase the skin produces and interfere with the transfer of melanin to the skin.

How much you need depends on the type of retinoid. Tretinoin, for example, works at 0.05-01.%; Adapalene at 0.1-0.3% and retinol at 4%. They work faster when used with other skin-lighteners. If you use them alone, it can take a few months to see a small improvement.

Retinoids also fight wrinkles and reduce acne. Unless you have sensitive skin, I do recommend you use them in your skincare routine together with another skin-lightener.

SIDE EFFECTS

All retinoids can cause stinging, redness, irritation and dryness. The stronger the form of retinol, the worse the side effects (that’s why some forms are available only by prescription).

BEST FOR

Anyone (bar those with sensitive skin) looking for a treatment for both hyperpigmentation and wrinkles.

BEST PICKS

  • MaeLove Moonlight Retinal Super Serum ($39.95): This retinal serum has a niacinamide + ceramide base to counteract the potential dryness and irritation from retinaldehyde. It also has fragrant oils that could irritate sensitive skin. But if your skin doesn’t react badly to them, it’s an effective and affordable option to consider. Available at MaeLove.
  • Skinceuticals Retinol 0.3 Night Cream ($62.00): This cream contains only 0.3% retinol but it packs an anti-aging punch. It comes in a moisturising base, but you need to use a separate moisturiser to counteract the dryness of retinol. Available at Dermstore and Skinceuticals.
  • Paula’s Choice 1% Retinol Booster ($52.00): This high-strength 1% retinol booster has a moisturising base and plenty of skin-soothers to counteract the irritating effects of retinol. Use it on its own for maximum effect or dilute it with moisturiser if it’s too harsh for you. Available at Cult BeautyNet-A-PorterPaula’s Choice and SpaceNK.

Related: Three Reasons Why You Should Use Retinoids

Paula's Choice C15 Booster 02

7. Vitamin C

WHAT IT IS

Vitamin C is a powerful antioxidant found in many fruits and vegetables, including oranges, lemon and strawberries. L-Ascorbic Acid, the pure form, is the most effective, but the most unstable (i.e., it loses its antioxidant and skin-lightening powers quickly).

L-Ascorbic Acid is the form of Vitamin C I recommend you use for lightening dark spots. Brands will tell you that derivatives, like Tetrahexyldecyl Ascorbate or 3-O ethyl ascorbic acid work just as well – but I haven’t seen independent proof of that yet.

HOW IT WORKS: 

Vitamin C fights the free radicals that cause darkening of the skin. Through the same mechanism, it also prevents premature wrinkles and helps enhance the effectiveness of your sunscreen. Unless you have sensitive skin, this is another active you want in your skincare routine – even if you don’t have dark spots yet.

L-Ascorbic Acid works at 5% concentrations but I recommend at least 15% for lightening dark spots. Magnesium Ascorbic Phosphate, a derivative of vitamin C is effective at 10%. Both are less effective than hydroquinone (but gentler).

SIDE EFFECTS

It’s one of the mildest skin lighteners, but L-Ascorbic Acid can still irritate sensitive skin in high concentrations (15%+).

BEST FOR

L-Ascorbic Acid is best for those concerned by mild pigmentation and wrinkle-prevention.

BEST PICKS

  • MaeLove Glow Booster ($27.95): The cheapest Vitamin C serum in this list, it does everything the others do, but it contains a citrus extract that may be irritating for sensitive skin. Available at Maelove.
  • Paula’s Choice C15 Booster ($46.75): It’s enriched with Hyaluronic Acid and glycerin to deeply hydrate skin. Available at Cult BeautyDermstoreNet-A-PorterPaula’s ChoiceSephora, and SpaceNK.
  • Skinceuticals CE Ferulic ($169.00): The original Vitamin C serum, it costs an arm and a leg, but it works wonders and delivers what it promises. Available at Dermstore and Skinceuticals.

Related: Spotlight On Vitamin C In Skincare

8. Glycolic Acid

WHAT IT IS

A member of the exfoliating Alpha Hydroxy Acid (AHA) family, glycolic acid is derived from sugar cane. It’s the smallest members of this family, so it can penetrate skin and give you results faster.

HOW IT WORKS: 

Glycolic acid speeds up cellular turnover. In plain English, it means it accelerates the skin’s natural exfoliating process so that the uppermost, most-damaged, darkest dead cells give way to the newer, lighter ones underneath. Plus, it disperses basal layer melanin.

Glycolic Acid works at 5-10% contraptions in OTC products; 20% and higher in peels. OTC concentrations work best when combined with other-skin lighteners. Peels work better and faster, but they should be administered by dermatologists.

SIDE EFFECTS

It depends on the concentration. The higher it is, the more irritating it gets (that’s why you should never do peels at home!). Side effects include peeling, redness, and dryness.

BEST FOR

Mild to moderate hyperpigmentation.

BEST FOR

  • Drunk Elephant T.L.C. Framboos Glycolic Night Serum ($90.00): This exfoliant contains two exfoliants. Glycolic Acid to fade away dark spots and Salicylic Acid to unclog pores. Available at Cult BeautySephora and SpaceNK
  • Paula’s Choice Resist Daily Smoothing Treatment with 5% AHA ($33.00): A wonderful low strength Glycolic Acid exfoliant that makes skin softer, smoother, and brighter. Available at Paula’s Choice and Selfridges
  • The Ordinary Glycolic Acid 7% Toning Solution (£6.80): A gentle, no-frills Glycolic Acid exfoliant for people on a budget. Available at Beauty Bay and Cult Beauty

Related: The Complete Guide To Glycolic Acid

WHAT IT IS

Licorice extract is an extract derived from the Glycyrrhiza Glabra plant (I know it’s a crazy name, but that’s what you’ll see on ingredient lists).

HOW IT WORKS

Licorice extract contains glabridin, which inhibits tyrosinase and prevents UVB-induced pigmentation, and liquiritin, which disperses and removes melanin.

Studies were done at 10% and higher concentrations. Skincare products contain A LOT less! Usually around 1%. That’s not going to do much *sighs* That’s why it’s best to use them with other skin-lighteners.

SIDE EFFECTS

It’s one of the mildest skin-lighteners. Unless you’re allergic to it, it’s safe to use.

BEST FOR

Sensitive skin with mild to moderate hyperpigmentation.

BEST PICKS:

  • Neostrata Dark Spot Corrector ($30.00): A powerful exfoliant with 1% Kojic Acid, Ascorbic Acid (Pure Vitamin C), and Licorice Root Extract to brighten skin and fade away dark spots. It’s best suitable for dry skin. Available at Dermstore and Look Fantastic.
  • Drunk Elephant C-Firma Day Serum ($80.00): This powerful Vitamin C serum includes a bunch of antioxidants, including licorice extract, to fight wrinkles and brighten the complexion. Available at BootsCult BeautySephoraSpaceNK, and Ulta.
  • Paula’s Choice Calm Redness Relief Serum ($34.00): A soothing serum with every anti-inflammatory ingredient you can think of. Ideal for sensitive skin that gets easily irritated. Available at Cult BeautyPaula’s ChoiceSephoraSpaceNK.

Related: Three Reasons Why You Should Use Licorice For Brighter And Younger Skin

10. Mequinol

WHAT IT IS

Mequinol is a derivative of hydroquinone. It’s also called hydroquinone monomethyl ether and p-hydroxyanisole.

HOW IT WORKS

Mequinol seems to work like hydroquinone, by inhibiting the activity of tyrosinase and increasing the cytotoxicity of melanocytes.

It’s effective at 2% concentrations and often used with 0.01% tretinoin. It’s as effective as hydroquinone.

SIDE EFFECTS

It’s less harsh than hydroquinone, but can still cause irritations in some people. In some cases, it can cause temporary postinflammatory hyperpigmentation.

BEST FOR

Those with severe hyperpigmentation looking for an alternative to hydroquinone.

BEST PICKS

Prescription only. Talk to your dermatologist about using it.

The Verdict: What’s The Best Dark Spots Treatment?

The best dark spots treatment is the one that works best for you. What works for you may not work for someone else, so don’t be scared to try different options and see what works best for you. But here’s a quick recap.

If you have mild or new dark spots, use Vitamin C in the morning, retinol every other nights, and niacinamide in your moisturiser. If you have dry skin, you can alternate glycolic acid with retinol at night.

If you have moderate or old dark spots that don’t respond well to this mid routine, you can add either Azelaic acid or Alpha Arbutin to your routine.

As for the other dark spots treatments on this list, I recommend them only when the above doesn’t work.

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