Novel stabilized topical cysteamine efficacious in hyperpigmentation disorders
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Patients with hyperpigmentation disorders benefited from a novel stabilized formulation of topical cysteamine, according to meta-analysis findings.
“Cysteamine is an aminothiol naturally present in cells of the human body as an antioxidant resulting from the degradation of Coenzyme A,” Seemal R. Desai, MD, FAAD, of Innovative Dermatology in Plano, Texas, and colleagues wrote. “Physiologically it is well distributed in mammalian tissues.”
Cysteamine is also found in human milk in high concentrations. It can have a protective role and serve as an “intrinsic antioxidant,” according to the researchers.
They noted, however, that cysteamine oxidates rapidly and has a strong odor, which made it an unattractive option for topical use. However, the ability to stabilize cysteamine has minimized these concerns.
A number of data sets since 2015 have demonstrated that stabilized cysteamine is safe, effective and tolerable when applied topically.
For example, outcomes for 90 patients with melasma in two double-blind, randomized, placebo-controlled trials showed that stabilized cysteamine bested placebo as assessed by modified Melasma Area Severity Index (mMASI). In the first study, the drug was also more effective than placebo in terms of melanin index reduction. In the second, stabilized cysteamine showed improvement as evaluated by Mexameter, Dermacatch and Investigator Global Assessment parameters.
When compared to other standardized melasma therapies, stabilized cysteamine has performed well, according to the researchers. The approach yielded stronger outcomes than Modified Kingman Formula in a double-blind, randomized study and was comparable to Tranexamic Acid Mesotherapy in another trial. In the latter trial, stabilized cysteamine also had better tolerability than the comparator.
Yet another study showed that stabilized cysteamine was more effective than hydroquinone as measured by mMASI in patients with melasma.
Individuals with senile lentigines may also benefit from this therapy, according to the findings. The researchers noted that forthcoming results may demonstrate the efficacy of topical cysteamine in this patient population.
“Topical stabilized cysteamine can be regarded to as one of the most potent treatments available for hyperpigmentation disorders in humans,” the researchers wrote.
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Desai SR, et al. J Drugs Dermatol. 2021;doi:10.36849/jdd.6367.
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