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Anyone with dark spots or melasma knows how challenging dealing with facial discoloration can be. Many products have significant side effects, and finding one that won't irritate your skin endlessly or bleach the areas of your face that don't have hyperpigmentation can seem like searching for a needle in a haystack. Enter cysteamine, an antioxidant that double-board-certified plastic surgeon Jaimie DeRosa, MD, tells us "is a naturally found chemical compound that is biosynthesized in mammals, including humans, by the degradation of coenzyme A." Ahead, DeRosa and board-certified dermatologist Hadley King, MD, share all you need to know about cysteamine for skin, from who should use it to how it works.
Meet the Expert
- Hadley King, MD is a board-certified dermatologist in New York City.
- Jaimie DeRosa, MD, is a double-board-certified facial plastic surgeon, as well as the founder and lead facial plastic surgeon of DeRosa Center Plastic Surgery & Med Spa in Boston and Palm Beach.
Type of ingredient: Antioxidant
Main benefits: Safe, well-tolerated, can selectively target areas of skin that have hyperpigmentation
Who should use it: It's safe for most people, including people of color, though you shouldn't use it if you have vitiligo.
How often to use it: It can be used daily, and indefinitely—just be sure to wait an hour after washing your face.
Works well with: Vitamin C and phytic acid
Don’t use with: Other skin lighteners, such as hydroquinone.
What Is Cysteamine?
Cysteamine is a naturally occurring antioxidant that can be used for lightening pigmentation in the skin. "It inhibits the synthesis of melanin," King explains. "It is a naturally occurring antioxidant that can be found in the human body." DeRosa adds that cysteamine "has been used as a therapeutic for decades to treat a rare genetic lysosomal storage disorder, nephropathic cystinosis."
Cysteamine works for fading dark patches "by decreasing the amount of L-cystine in the cells, which is involved in the production of melanin, so it effectively works to decrease excess pigmentation in skin," according to DeRosa. She says that "this is great for those with skin conditions including hyperpigmentation, lentigines, post-inflammatory hyperpigmentation (PIH), and melasma." While cysteamine is naturally occurring and safe for most people, King points out that those with vitiligo should avoid it, plus it hasn't been tested for use during pregnancy and breastfeeding, so those groups should steer clear as well.
As far as who can use it, cysteamine works for a wide variety of skin types and conditions. "Cysteamine is best for anyone struggling with hyperpigmentation issues, especially those who would like to avoid hydroquinone, which is banned in the EU as a possible carcinogen, or corticosteroid-containing skin lightening products, which can thin out the skin," DeRosa tells us.
Benefits of Cysteamine for Skin
While you do have options when it comes to ingredients that can help fade pigmentation, there are several reasons you might choose cysteamine over others:
- It's naturally occurring in the body: Cysteamine is an antioxidant that our body manufactures on its own. "Cysteamine is a skin-lightening agent that can be found in the body's skin cells," DeRosa explains. "This powerful antioxidant reduces the melanin production in the skin to visibly improve stubborn brown patches. Importantly, since it is not a bleach, 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."
- Comparatively gentle: As far as skin-lightening ingredients go, cysteamine is on the safer side. DeRosa says that cysteamine is "safer than other lightening products available, including hydroquinone (HQ)."
- Well-tolerated with consistent use: Cysteamine can be used on an ongoing basis, and it works well on a wide range of skin tones. "It is well tolerated and does not require ‘breaks’ in use, as compared to hydroquinone and corticosteroids," DeRosa tells us. "It is even tolerated by those with darker skin types (so-called Fitzpatrick V and VIs)."
Side Effects of Cysteamine
Even though it's a naturally occurring antioxidant, cysteamine can still be irritating to your skin, and it can potentially cause dryness or irritation, according to King. To prevent dryness, "it should not be applied until an hour after cleansing in order to reduce this risk," she says. "It may also be easier to apply before washing, then wash it off after the specified contact time. Moisturizers can help to combat dryness [as well]."
If you experience a bit of tingling or sensitivity on your skin after applying cysteamine to your skin, it's not necessarily cause for alarm, as King says that "there can also be a temporary burning sensation that will resolve within about half an hour." That being said, if the burning is intense or doesn't go away, stop use and talk to your dermatologist about next steps.
How to Use Cysteamine for Skin
For best results, follow the instructions of whatever cysteamine product you're using and/or the advice of your dermatologist. Some products are only left on for a short while, then washed off. King notes that no matter how you're using cysteamine, "rigorous sun protection should be followed in order to maximize results."
"When you add cysteamine to your skincare regimen, my recommendation is to start slowly and not mix other active ingredients with it to start just to be sure your skin tolerates it, which it should," DeRosa says. "You can then add skin brighteners and/or antioxidants, such as vitamin C and phytic acid. I would also avoid using hydroquinone with this, as cysteamine should work as well or better, so no need to double up."
What is cysteamine used for?
Cysteamine's primary use is to fade pigmentation and lighten skin. Unlike some other skin lightening agents, it will only lighten hyperpigmentation, not all of your skin.
Does cysteamine lighten skin?
Yes, lightening areas of skin with excess pigmentation is the primary use of cysteamine. However, the product is meant to target dark spots, post-inflammatory hyperpigmentation, and melasma while leaving your overall skin tone intact.
Is cysteamine better than hydroquinone?
Both cysteamine and hydroquinone are useful for fading pigmentation and lightening skin. However, cysteamine may have fewer side effects than hydroquinone does.
Is cysteamine cream safe?
Yes, cysteamine cream is generally considered safe. However, you should avoid using it if you are pregnant or breastfeeding, or if you have vitiligo.