Got Pigmentation? Derms Can’t Stop Raving About Cysteamine, the Safe Counterpart to Hydroquinone

For those who experience dark spots and pigmentation, you’ll know that there are many “brightening” skincare products that don’t actually work how you’d like them to. That’s because they often contain brightening ingredients, like kojic acid and vitamin C, that work to brighten skin tone, but not necessarily lighten skin.  

For that you need something like cysteamine, an ingredient praised for its ability to decrease melanin pigment and fade dark spots on the skin when applied topically. It can even help prevent future pigmentation, according to board-certified dermatologist Jeremy Brauer, MD. 

We spoke to a few skin experts to help us get to the bottom of how cysteamine can help those who struggle with pigmentation. 

What is pigmentation?

“In the context of skin, hyperpigmentation is the presence of darkened spots, or patches anywhere on the skin caused by overactive melanocytes and over-production of the pigment melanin,” says Jaimie DeRosa, MD, double board-certified facial plastic surgeon.

The thing about pigmentation is that it doesn't just fit in one box. Any change in melanin (your skin color) can lead to pigment disorders—possibly caused by picking at acne, cuts, or sun exposure. It can also lead to hypopigmentation (light spots), and depigmentation (white spots or patches). 

What is cysteamine? 

Cysteamine is a skin-lightening agent that can be found in the body’s skin cells. “This powerful antioxidant reduces the melanin production in the skin to visibly improve stubborn brown patches,” says Dr. DeRosa. “It has been used as a therapeutic for decades to treat a rare genetic lysosomal storage disorder, called nephropathic cystinosis.”

Importantly, it is not a bleach, so the skin does not lose the amount of melanin (and therefore pigment) in the skin. Instead, it just removes the excess pigment that causes hyperpigmentation. This means it’s a great option for those who could not tolerate, or are otherwise not candidates for, hydroquinone (which has courted controversy for years and is banned from OTC products). In fact, a Harvard professor in the 1960s discovered that cysteamine was stronger than hydroquinone for fading pigment in skin-tissue samples.

“When applied topically to the skin, it can reduce pigmentation as well as scavenge free radicals,” says Dr. Brauer. Because cysteamine decreases the amount of L-cystine, which is involved in the production of melanin, it has also been found to decrease hypopigmentation and melasma. 

How long does it take to see results from using cysteamine?

After using cysteamine cream, Dr. DeRosa says studies have shown that 94% of dark patches and dark spots were less noticeable in 16 weeks, but in some cases, results can be seen in 4 weeks. Depending on the severity of your pigmentation, you may experience improvement at different rates than others. 

Best Products with Cysteamine

The best thing about cysteamine? It can be acquired without a doctor’s prescription. Shop dermatologist-approved products with cysteamine for pigmentation, below.