Stabilized cysteamine is a substance that has gained attention for its potential use in treating pigmentation disorders. It plays a role in various physiological processes, including the regulation of melanin synthesis. Stabilized cysteamine refers to a modified form of cysteamine that has been chemically altered to enhance its stability, effectiveness, and shelf life. This modified form is typically used in topical formulations for the treatment of hyperpigmentation. 

CYSTEAMINE AT WORK

The exact mechanism of action of stabilized cysteamine in pigmentation disorders is not fully understood. However, it is believed to work through multiple pathways to both prevent hyperpigmentation and reduce existing pigment. One of the key mechanisms is its ability to inhibit the activity of an enzyme called tyrosinase. Tyrosinase is responsible for the conversion of the amino acid tyrosine into melanin precursors. By inhibiting tyrosinase, stabilized cysteamine can reduce the production of melanin, leading to a skin lightening effect. 

Additionally, stabilized cysteamine has been shown to possess antioxidant properties. Oxidative stress, caused by an imbalance between the production of reactive oxygen species (ROS) and the body’s antioxidant defenses, can contribute to pigmentation disorders. By acting as an antioxidant, stabilized cysteamine can help reduce oxidative stress and its detrimental effects on melanocytes, the cells responsible for melanin production. 

LIGHTEN UP

Clinical studies have demonstrated the efficacy of stabilized cysteamine in treating various forms of hyperpigmentation. For example, melasma is a common hyperpigmentation disorder characterized by brownish patches on the face. In a study published in the Journal of Drugs in Dermatology, topical application of stabilized cysteamine showed significant improvement in melasma compared to a placebo. The treatment resulted in lightening of the hyperpigmented areas and an overall improvement in skin tone.¹ 

Another pigmentation disorder where stabilized cysteamine has shown promise is post-inflammatory hyperpigmentation (PIH). Post-inflammatory hyperpigmentation is characterized by dark spots or patches that occur after an inflammatory skin condition, such as acne or eczema, as well as after skin treatments, such as lasers and microneedling. In a study published in the Journal of Cosmetic Dermatology, stabilized cysteamine was found to effectively reduce post-inflammatory hyperpigmentation and improve overall skin appearance.²

SAFETY FIRST

One of the important advantages of stabilized cysteamine is its safety profile. It is generally well-tolerated and has minimal side effects compared to other pigmentation treatments, such as hydroquinone (HQ) or corticosteroids. Clinical trials have shown that it works as well as 4% hydroquinone without the harmful side-effect profile, which includes worsening pigmentation, eye damage, and even cancer. Cysteamine is safe to use for all skin tones and does not require breaks after prolonged use.¹ These benefits and excellent safety profile make stabilized cysteamine a real game-changer. At the DeRosa Facial Plastic Surgery and Medical Spa, we perform services that can trigger post-inflammatory hyperpigmentation, such as laser resurfacing, radiofrequency microneedling, and facial rejuvenation surgeries as well. Moreover, we have a lot of patients with a range of Fitzpatrick types, including Fitzpatrick V and VI, who suffer from melasma and or hyperpigmentation and are looking for safe, topical treatments. Stabilized cysteamine is my go-to product for these issues. 

Stabilized cysteamine has emerged as a promising treatment option for various pigmentation disorders, particularly hyperpigmentation. Through its inhibitory effects on tyrosinase and its antioxidant properties, stabilized cysteamine can help reduce melanin production and oxidative stress, leading to a lightening effect on skin. Clinical studies have demonstrated its efficacy in treating conditions like melasma and post-inflammatory hyperpigmentation. With its favorable safety profile, stabilized cysteamine offers a potentially valuable therapeutic approach for individuals seeking to address pigmentation concerns without the safety concerns of hydroquinone. 

References

1. Desai, S. R., et al. “Topical Stabilized Cysteamine as a New Treatment for Hyperpigmentation Disorders: Melasma, Post-Inflammatory Hyperpigmentation and Lentigines." Journal of Drugs in Dermatology 20, no. 12 (2021): 1276-1279.

2. Ahramiyanpour, N., et al. “Efficacy of Topical Cysteamine Hydrochloride in Treating Melasma: A Systemic Review.” Journal of Cosmetic Dermatology 20, no. 11 (2021): 3593-3602.

Dr. Jaimie DeRosa is a double-board certified facial plastic and reconstructive surgeon. She devotes her practice to facial plastic surgery, with a special interest in rhinoplasty and aging face surgery. Dr. DeRosa works diligently to address the needs of her patients in the safest and most meticulous manner possible, keeping her patients’ needs her top priority. She strives to achieve natural results that will stand the test of time. Dr. Jaimie DeRosa is the founder and lead physician of the DeRosa Center and Med Spa on Newbury Street in Boston and the DeRosa Clinic Palm Beach. Dr. DeRosa spends time each month in both the Boston and Palm Beach DeRosa Clinic locations. Dr. DeRosa is an assistant professor of Otolaryngology at Harvard Medical School and has been an invited lecturer throughout the United States and abroad.