Efficacy of D-pigment dermocosmetic lightening product for solar lentigo lesions of the hand: A randomized controlled trial

Abstract

Solar lentigo, benign lesions which mostly appear on chronically, sun-exposed surfaces, are associated with ageing. Patients are increasingly requesting a more uniform skin texture, especially for hands. Treatment options include dermoabrasion, intense pulsed light, cryotherapy, peelings, and laser therapy. Topical compounds can be employed, in alternative or associated with dermatologic procedures. The current study was designed to evaluate solar lentigo hyperpigmentation, skin architecture and clinician and patient assessments comparing a dermocosmetic lightening product (active) with a moisturizing product (control) according to clinical, digital and subjective analyses in 72 lesions over 12-month follow up period. Statistically significant differences were observed between the lesions treated with the active compared to the control in terms of papillary brightness (p = 0.03) and contrast (p = 0.03), and in the limitation of dermal-epidermal junction destructuring (p = 0.03) according to dermal-epidermal junction destructuring score at Reflectance Confocal Microscopy. Luminance (p = 0.04) and redness (p = 0.03) were improved at color analysis, and physician and patient evaluations favored the active in efficacy and patient satisfaction investigations. The dermocosmetic lightening product utilized in the current study proved to be more effective, according to clinical, digital and subjective analyses in reducing lesion hyperpigmentation, stabilizing the lesion skin architecture and increasing patient satisfaction compared to the control in a cohort of 36 subjects, over a 12-month period. Beside demonstrating the efficacy of this topical lightening product, we propose a “destructuring score”, which improves the robustness of solar lentigo’s evaluation, and can be used in future studies to standardize the quantitative comparisons of different treatment options.

Skin dark spot mapping and evaluation of brightening product efficacy using Line‐field Confocal Optical Coherence Tomography (LC‐OCT)

“…However, Arginelli et al demonstrated a quantitative restriction of natural DEJ destructuring on solar lentigines with the use of a dermocosmetic brightening product over a 12-month follow-up period. 37 Taken together, these findings suggest that the modulation in DEJ pattern seems to be not detectable in a short time frame, as in the present study. Future investigations with an extended treatment duration are needed to validate the long-term efficacy of our brightening product in correcting DEJ.…”

“…Results showed that melanin density levels were reduced by 7% within the dark spots and 12% within their surrounding area after 2 months of full‐face application by Asian women. The observed skin‐brightening effect, validated by the SkinCam tool, became apparent within the first month of treatment and persisted throughout the study, suggesting a relatively rapid efficacy compared to other products in clinical trials 35–37 …”

“…The observed skin-brightening effect, validated by the SkinCam tool, became apparent within the first month of treatment and persisted throughout the study, suggesting a relatively rapid efficacy compared to other products in clinical trials. [35][36][37] Clinical studies often rely on clinical scoring as a single endpoint to assess the brightening effect of active ingredients on solar lentigines. 35,36,38 For instance, a reduction in hyperpigmentation or a notable decrease in melanin score was observed after 3 months of using a hydroquinone cream.…”

“…However, the Mexameter, a spectrometric device, 41 lacks the capability to provide data on epidermal structure, a feature offered by imaging tools such as LC-OCT. 26 RCM was also used to assess the effectiveness of dermocosmetic brightening products. 37 The researchers noted a notable reduction in the brightness and contrast of papillae through a semi-quantitative assessment/scoring based on 2D horizontal images. 37 The disparity in the assessment tools' performance and metrics complicates direct comparisons between our brightening product effectiveness and that of other products.…”

“…The observed skin‐brightening effect, validated by the SkinCam tool, became apparent within the first month of treatment and persisted throughout the study, suggesting a relatively rapid efficacy compared to other products in clinical trials. 35 , 36 , 37 …”