Does Ambi Fade Cream Really Work?

Dear Nicki,

I noticed Ambi Fade Cream at my local drugstore, and I was wondering if it works.  Any thoughts?

Sincerely,

Jamie

Dear Jamie,

In a word:  YES, Ambi Fade Cream ($7.98, Amazon.com) does in fact work.  For the exceptionally low price – just $3.99 an ounce – it sounds almost too good to be true.  Yet it isn’t.

The secret:  Hydroquinone

A 2% concentration of hydroquinone is the secret to Ambi Fade Cream.  Generally available over-the-counter in 2% concentration and in prescription formulas in 4% concentration, hydroquinone has been FDA-approved for the treatment of freckles, melasma, and general brown patching since 1982.

Hydroquinone works by inhibiting the activity of tyrosinase, the rate-limiting enzyme of melanin production, and by increasing the cytotoxicity of melanocytes (melanin-producing cells).  Its efficacy has been well-established over time, including in a 2003 study in The International Journal of Dermatology, where it was found to reduce signs of hyperpigmentation associated with melasma by a whopping 76.9%, beating another skin whitening complex at 66.7%.

But Wait:  Isn’t Hydroquinone Controversial?

Yes and no.  Hydroquinone has been banned in some countries, including France and South Africa, for concerns about increased cancer risk and ochronosis (darkening of the skin) with its use.

In 2010, the U.S. FDA raised concerns about the use of hydroquinone and other skin-bleaching agents, as they reported that they wish to “re-establish that over-the-counter (OTC) skin bleaching drug products are not generally recognized as safe and effective.”

Yet most dermatologists and skin care experts in the U.S. are not concerned.  According to renowned dark skin expert Dr. Susan C. Taylor, M.D., a Philadelphia-based dermatologist,”The maximum levels of hydroquinone currently allowed (2 percent for over the counter, 4 percent for prescription) aren’t dangerous. At worst, it might cause redness or irritation, but only if your skin is sensitive or allergic to the medication.”

What’s more, the studies that implied hydroquinone may be harmful stemmed from an early study that demonstrated mice exposed to hydroquinone developed liver tumors.  However, according to a 2006 review in the Journal of the American Academy of Dermatology, these results were reported in a misleading fashion.  Rather, hydroquinone increased the number of benign liver tumors, reducing the proportion of cancerous liver tumors in the mouse, showing a protective effect of hydroquinone.  (For you science buffs out there, there was an increase in hepatic adenomas and a decrease in hepatocellular carcinomas).  It has further been argued that kidney tumors associated with hydroquinone in the mouse do not appear relevant to humans after decades of widespread use.  As such, it seems that topically applied treatments with hydroquinone are safe, as Dr. David J. Goldberg, a clinical professor of dermatology at the Mount Sinai School of Medicine states, “Over 100 scientific articles confirm hydroquinone is a safe topical for humans; no independent studies prove the opposite.”

What to Expect from Ambi Fade Cream 

With that said, expect Ambi Fade Cream to improve signs of hyperpigmentation (i.e., uneven pigmentation, age spots) within 4-6 weeks of daily use.  In addition to 2% hydroquinone, Ambi Fade Cream also contains soy protein and lactic acid, which have both been demonstrated to have milder but still mentionable effects on hyperpigmentation as well.  As far as drugstore products go, I have not found one better for signs of hyperpigmentation than Ambi Fade Cream.

However, my qualm about the product is that it says it contains “sunscreen.”  First and foremost, as a general rule of thumb for my readers, applying to this or any other product:  If it doesn’t list the SPF on the package, it doesn’t provide enough UV coverage to be used as your sole form of sun protection.  Period.  Ambi Fade Cream contains 2% octinoxate, which breaks down in the presence of other sunscreens containing avobenzone (Photochemistry and Photobiology, 2007).