Skincare with Friends Episode 66. How to Use Vitamin C to Get Results: Is There any Evidence that it Actually Improve Melasma or Hyperpigmentation?

This is part of the Skincare with Friends Vitamin C series. We’ve answered these questions already-

• What is Vitamin C?
• Can your Vitamin C Serum Absorb into the Skin?
• Can Vitamin C Boost Sunscreen?
• What to Buy? Which Vitamin C Products are Good and Effective Based on this Science?
• Can We Increase the Amount of Vit C by Supplementing? If We Take Loads Will it Get into Our Skin?
• Is it Worth Using a Topical Vitamin C for Aging?
• Are Vitamin C Derivatives Any Good?
• How to Use Vitamin C to get the Best Results by using Iontophoresis, Microneedling and Exfoliation

Click the links to find out the answers or listen to the podcast by searching “Skincare with Friends” wherever you listen to podcasts. Please support the work we are doing by liking and subscribing to our podcast (that old chestnut, but if we don’t get feedback, how will we know if we’re doing a good job?). You can also follow us on our socials- @niapattenlooks, @natswf, @skincarewithfriends. The links in this post may be affiliate, if you click and buy something we will get a small percentage that goes back into making our podcast.

Today we’re going to look at what the evidence has to say about the effect Vitamin C has on melasma and hyperpigmentation. Hyperpigmentation is one of the things that Vit C is known to help with, “brightening” is often written on the vitamin C skincare sales bumf. I was pretty surprised when I got to searching for scientific evidence, by what I found…

There isn’t a vast amount of research done on Vitamin C as a standalone treatment for melasma, which is surprising. Most of the studies analyse the effect of vit C alongside other actives, or using techniques like Microneedling, rather than assessing it’s effect as a solo treatment.

“Whether vitamin C can inhibit melanogenesis is controversial. Most studies have agreed that although it cannot kill melanocytes, vitamin C does inhibit melanogenesis; Furthermore, the combination of vitamin C and vitamin E inhibits melanocyte production more significantly than vitamin C alone”.

(Wang, 2018).

Here are some studies I found comparing Vitamin C to other popular melasma treatments, Hydroquinone and Tranexamic Acid, but there isn’t much more evidence in it’s favour as a treatment for pigmentation. Most of the studies use Vitamin C in combination with Microneedling, Iontophoresis or other treatments like laser (check out our post on this).

The studies I’ve found don’t tend to be of great quality, not blinded or of a large sample size. Good studies should have a lot of people to test on, the bigger the better. The best type of studies are randomised double blind controlled studies, which means that neither the person performing the test or the person having the test knows whether they’ve got the active ingredient, like vitamin C or placebo, also known as the control. There are no randomised double blind controlled studies with large sample sizes investigating whether vitamin C works for melasma. So the best that we are going to be able to say is that it might work.

Vitamin C vs Hydroquinone for Melasma

I found one study where they used Vit C on one side and Hydroquinone on the other side of the participant’s face over the course of 4 months, they found that

“Vit C minimizes oxidized melanin, changing the pigmentation from black to tan. Consequently, ascorbic acid may have an important effect on hyperpigmentation, such as in melasma. In our trial, it was observed that, with 5% l-ascorbic acid, 62.5% of patients showed good or excellent subjective results, confirming the lightening effect. Colorimetric assessment showed no statistical difference between the two treatments (P = 0.052), implying that the melanin component decreased similarly in the two treatments”

(Espinall-Perez, 2004).

This is a small study with only 16 people but it raises an interesting fact- that vitamin C could change the tone of the pigmentation from dark/black to brown/tan. So it might be something that improves pigmentation as opposed to removing it. personally, I certainly find that hydroquinone can remove it pigmentation entirely.

Vitamin C vs Tranexamic Acid for Melasma

Another 2020 study by Menon et al compared Ascorbic Acid with Tranexamic Acid in a split face study using micro needling to help penetration. 30 women had 2 miconeedling treatments with 1.5mm needles 1 month apart with TXA on one side and 20% L-AA on the other. Both treatments were effective but the TXA worked better. The results are definitely visible after just 2 treatments.

The studies here are small, but they are the best I could find. The Vitamin C had a visible effect, but probably not as marked an effect as the Hydroquinone or Tranexamic Acid as you can see from the pictures.

The Final Verdict- Is it Worth Using Vitamin C if You Have Melasma?

It looks like vitamin C might help with melasma, but most of the studies use a delivery mechanism like iontophoresis, microneedling or laser or pair it with another depigmenting agent like Kojic acid. It looks like it can lighten the tone of the pigmentation from black to brown as opposed to removing it completely. It certainly boosts the effect of sunscreen and works as an antioxidant, which can help prevent melasma worsening.

If you have severe pigmentation you’re better off looking at ingredients with better evidence behind them, like Tranexamic Acid or Hydroquinone, which can actually remove pigmentation. And treat Vitamin C as supportive treatment to help with sun protection.

References

Espinal-Perez, L. E., Moncada, B., & Castanedo-Cazares, J. P. (2004). “A double-blind randomized trial of 5% ascorbic acid vs. 4% hydroquinone in melasma” International Journal of Dermatology, 43(8), 604–607. doi:10.1111/j.1365-4632.2004.02134.x 

Menon A, Eram H, Kamath PR, Goel S, Babu AM. (2020) “A split face comparative study of safety and efficacy of microneedling with tranexamic acid versus microneedling with Vitamin C in the treatment of melasma”. Indian Dermatol Online J 11:41-5. Available from: https://www.idoj.in/text.asp?2020/11/1/41/261220