PATH-3 Technology outperforms hydroquinone in treatment of facial dyschromia

Key takeaways:

• The formulation achieved significant improvements in left and right cheeks, combined cheeks and total facial area by week 12.
• The formulation had no adverse events and was “well-liked by subjects.”

A topical formulation with PATH-3 Technology outperformed hydroquinone 4% in the treatment of mild to severe facial dyschromia, according to a study.

“Hydroquinone has become the gold standard topical for lightening hyperpigmentation of the skin,” Jordan V. Wang, MD, MBE, MBA, the medical research director at Laser & Skin Surgery Center of New York, and colleagues wrote. “However, it is often associated with various side effects, including irritation, burning and stinging.”

Coupled with the fact that hydroquinone has been removed from over-the-counter markets for concerns of cytotoxic and carcinogenic properties, according to the study, new treatments for hyperpigmentation are needed.

In this multicenter, randomized, blinded clinical study, the authors evaluated the efficacy and safety of A-Luminate (AL; Alastin Skincare) brightening serum, a novel, topical formulation with PATH-3 Technology. According to the study, PATH-3 Technology counteracts pigmentary pathways and is validated through gene expression studies examining melanocyte, keratinocyte and endothelial cell lines, as well as models of melanocyte production.

Forty-three patients with mild to severe facial dyschromia aged 18 to 71 years were randomly assigned to use AL (n = 22) or hydroquinone 4% (n = 21) twice daily for 12 weeks. Each patient was also given a cleanser, sunscreen and moisturizer.

At weeks 4, 8 and 12, investigators followed-up with patients and assessed results according to the modified Melasma Area Severity Index (mMASI) and modified Griffiths scales.

Results showed that AL-treated patients achieved significant improvements in mMASI scores in the right cheek (–1.9 points; P = .0097), left cheek (–1.6 points; P = .0123), combined cheeks (–1.8 points; P = .0019) and total facial area (–1.5 points; P = .0046) by week 12. Patients treated with hydroquinone 4% did not achieve significant improvement in any of these areas.

The AL cohort also saw significant improvement from baseline to final follow-up in facial dyschromia (P = .0008); skin tone, clarity and evenness (P = .0002); and radiance (P = .0015). Hydroquinone 4% achieved significant improvement in dyschromia (P = .0059) and skin tone, clarity and evenness (P = .0037), but not in radiance.

AL particularly showed greater results in skin texture, with a mean change of –0.7 points (P = .0058) compared with the hydroquinone 4% cohort, which did not show any improvement.

A higher rate of adverse events was observed in the hydroquinone 4% group compared with the AL group. Those treated with hydroquinone 4% exhibited five adverse events, including three with contact dermatitis, and one each with eyelid erythema and acne. Those treated with AL, on the other hand, experienced no adverse events.

Patients taking hydroquinone 4% vs. AL also more often reported burning/stinging, tingling, itching, erythema and dryness.

“The novel PATH-3 Technology, designed to counteract various steps in pigmentation pathways, has been demonstrated to be safe and effective in treating facial dyschromia,” the authors concluded. “This product was also well-tolerated and well-liked by subjects.”

Editor's note: This article was updated on May 22, 2023, to make a correction to the infographic.