Skin lightening preparations are widely used in dermatology by persons of all Fitzpatrick skin types. Fitzpatrick skin types I-III require local pigment lightening for the treatment of hormonally induced melasma and postinflammatory hyperpigmentation caused by acne and trauma. Fitzpatrick skin types IV and darker have an even greater need for skin lightening for social reasons, as well as pigmentary changes that occur around the eyes, in the intertriginous areas, following dermatitis, or with acne and trauma. The gold standard dermatologic agent for skin lightening was hydroquinone, until regulatory agencies in Japan, Europe, and most recently in the United States questioned the safety of this substance. This has encouraged research into alternative agents to inhibit skin pigmentation such as retinoids, mequinol, azelaic acid, arbutin, kojic acid, aleosin, licorice extract, ascorbic acid, soy proteins, and N-acetyl glucosamine. The efficacy and safety of each of these ingredients is examined as possible topical alternatives to hydroquinone.

Background: The presence of sebum on the face is responsible for both facial shine and the formation of comedonal and inflammatory acne lesions. Sebum control is a goal of many OTC skin care products; however, most currently available products function by absorbing sebum from the face rather than modulating its production. Objective: To demonstrate the effect of topical 2% niacinamide on sebum excretion rates and casual sebum production in Oriental and Caucasian populations. Methods: Separate clinical trials were conducted in both Japan and the USA to evaluate the effect of topical 2% niacinamide in different ethnic groups. A total of 100 Japanese subjects were enrolled in a double‐blind, placebo‐controlled comparison between two independent balanced groups. Fifty subjects applied the 2% niacinamide moisturizer to the face for 4 weeks and 50 subjects used a placebo moisturizer for 4 weeks, with sebum excretion rate (SER) measurements taken at baseline, week 2, and week 4. In addition, 30 Caucasian subjects were enrolled in a randomized split‐face study for 6 weeks with SER and casual sebum levels (CSL) measured at baseline, week 3, and week 6. Results: The results of the Japanese study demonstrated that the SER of the two groups was not significantly different at baseline, but the 2% niacinamide treated group demonstrated significantly lowered SER after 2 and 4 weeks of application. The results were somewhat different in the Caucasian study. After 6 weeks of treatment, the CSL was significantly reduced, but the SER was not significantly reduced. Conclusions: Topical 2% niacinamide may be effective in lowering the SER in Japanese individuals and CSL in Caucasian individuals.