ASTRINGENTS & BLEACHING

AGENTS
BY- DR. SUJATA MAURYA
Astringents are compounds used to reduce exudation by precipitation of protein.

In medical practice – it causes contraction of tissues, arrest of secretion or control of

bleeding.

MECHANISM OF ACTION

• Coagulate protein.
• The protein precipitate that is formed acts as a protective coat, allowing new tissue
to regenerate underneath.
• reduce oozing in acute eczema.
• They are used after cleansing but before moisturizing, and they are left on the
face following use.

• Astringents are usually liquids wiped over the face with a cotton ball.

• Astringents are used to remove the oily residue left behind after cleansing of
the face with lipid-free cleansers or cleansing creams.

• Oily complexion astringents are formulated to remove any remaining sebum

from the face following synthetic detergent cleansing or to deliver
keratolytics, such as salicylic acid, glycolic acid or witch hazel.

• Some astringents designed for dry skin contain a humectant liquid

moisturizer, such as propylene glycol or glycerin, and skin soothing agents,
such as allantoin, guaiazulene or quaternium-19
Most frequently employed are aqueous solutions of

1. Potassium permanganate,
2. Aluminium acetate and
3. Silver nitrate.
 POTASSIUM PERMANGANATE
Molecular formula – KMNO4

appears as a purplish colored crystalline solid

Mechanism of action
1. Astringent: it draws water out of the cells leading to
drying of oozy lesions.

2. It is an oxidising agent liberating nascent oxygen, responsible for its

antibacterial and anti-fungal properties.
3. Anti-pruritic and anti-inflammatory properties.
4. Promotes the formation of granulation tissue and collagen synthesis,
which are essential for the healing process. 
 INDICATIONS
1. Weeping lesions of dermatitis-
• atopic dermatitis,
• allergic contact dermatitis
• irritant contact dermatitis.
2. Chronic leg ulcers—venous ulcers and diabetic ulcers.
3. Oozing lesions of bullous disorders like pemphigus foliaceus or vulgaris.
4. Haemorrhagic crusts over the vermillion lip in stevens-johnson syndrome.
5. Condy’s gargles may be used for the management of oral ulcers.
However, extra dilutions are needed for mucosal surfaces to prevent
irritation and paradoxical ulceration.
Available form
• 20gm sachets of crystals. Rs. 56/-

Storage
• It is advisable to store it in a dry
and airtight packet.
• It also removes the bad odor associated with exudative lesions
(deodorize wounds).

• For medicinal purposes is diluted to 1:10,000 which is usually

achieved by dissolving 400 mg of potassium permanganate in 4 L of
water

• A medicated bath containing 1: 25,000 potassium permanganate can

be prepared by adding 2 g to 50 L of water.

• The contact time for soak solution should be <15 minutes as

oxidation makes it ineffective
 METHOD
• Applied by dipping the affected area in the solution in a bucket or bath depending on
the size and site of involved area. Extra care is necessary for genitals.

• Another effective method is the application of gauze swabs or clean cotton soft cloth
folded in several layers soaked in condy’s solution on the affected areas, called
condy’s compresses (preferably dipping/soaking the gauge piece every 3–4 minutes
for 10–15 minutes

• Yellowish-brown discoloration of the solution indicates its end of effectiveness

• A practical method of preparing potassium permanganate solution
where weighing is not possible, that gives solution approximately
equal to a concentration of 1:4000 to 1:8000 is as follows:

A pinch of crystals is dissolved in a small bottle.

This solution is added drop by drop to a basin containing water until the color of
the water in the basin turns light pink (as pink as your nail).

This can be used for compresses (Condy’s compresses).

 SIDE EFFECTS AND THEIR PREVENTION
1. It is corrosive and may cause burns; hence the extra precaution for dilutions and
ensuring complete and uniform dissolution of the crystals.Special care is needed to
avoid its contact with mucosae.
2. Temporary skin and nail discoloration are common-Nails can be covered with
paraffin to prevent this. Fresh stains over the skin can be removed by rubbing a damp
tablet of vitamin C over the affected areas.
3. Patients should be warned about the staining of fabrics and ceramic vessels/bathtubs.
4. This product must be kept out of reach of children as it is nephrotoxic and
hepatotoxic if ingested.
• Crystals should never be added directly to the water intended for use.

• The crystals should not be mixed in an aluminum or metallic container.

• The solution should be freshly prepared.

• temporary brown or bright purple staining of the skin, which may be

removed with a weak solution of oxalic acid or sodium thiosulfate.
The benefits of potassium permanganate include

• lower cost
• a reduced rate of allergies and
• a significantly higher healing rate compared with other medications 
• “Warning - for external use on the skin only. Severe injury may result from use
internally or as a douche. Avoid contact with mucous membranes.”

• Fda approved dose for medication –aqueous solution containing not more than
0.04%
 ALUMINIUM ACETATE

• Also known as Burow's solution, this astringent is mildly antiseptic and

has the advantage of not causing the staining associated with potassium
permanganate.

• The solution is prepared using aluminium sulphate, acetic acid, tartaric

acid and calcium carbonate.

• The solution contains 5% aluminium acetate and is diluted 1 : 10 to 1 :

40 with water for use in soaks, rinses or wet dressings .
• Nonprescription aluminum sulfate and calcium acetate (domeboro) are available
and, when dissolved in water, a chemical reaction occurs forming aluminum
acetate and a precipitate of calcium sulfate (modified burow solution)

Used in a variety of skin conditions:

• Insect bites
• Poison ivy, oak, sumac
• Allergic contact dermatitis
 SILVER NITRATE

• In concentrations of 0.1–0.5% silver nitrate is an effective astringent and

antiseptic often used in management of leg ulcers and burns.

• Mechanism of action – precipitation of bacterial proteins by free silver

ions.
• valuable in the treatment of infected eczema, gravitational ulcers, and other
weeping and/or infected skin lesions, cauterization of wounds, removal of
granulation tissue, aseptic prophylaxis of burns.

• against S. aureus, S. epidermidis, and P. aeruginosa.

• solid form ---- used as hemostat.

• bacteriostatic at low concentrations (0.5%, used clinically)

• bactericidal at higher concentrations (10%).

• Higher concentrations may cause pain.

• Stains the skin and most other materials black.

• Its cosmetic disadvantage is outweighed by the rapid resolution of resistant weeping
and superficial infections.

• Concentrated form ---- extremely toxic to tissues

• Methemoglobinemia secondary to topical treatment.

• Thus if prolonged use --- methemoglobin levels should be followed.

• Pregnancy category - c
BLEACHING AGENTS
Bleaching agents are used in treating hyperpigmentary disorders such as

• Melasma,
• Post-inflammatory hyperpigmentation,
• Drug and cosmetics-induced hyperpigmentation,
• Pigmentation following photoxic and photosensitizing agents,
• Lentigens
 HYDROQUINONE
• Hydroquinone (HQ), aka dihydroxybenzene, is a hydroxyphenolic
compound that is structurally similar to precursors of melanin.

• It inhibits the conversion of DOPA to melanin by inhibition of the

enzyme, tyrosinase.

• HQ affects not only the formation, melanization, and degradation

of melanosomes, but it also affects the membranous structures of
melanocytes and eventually causes necrosis of whole melanocytes
• HQ is an oxidizing agent, generate reactive oxygen species.
• 2 to 5% applied once daily
• Effect in 6-7weeks
• Continue for 3 months to 1 yr
• Hydroquinone 4%
• Rs. 115/-
• Hydroquinone (2% w/w) + Tretinoin (0
.025% w/w) + Fluocinolone acetonide (
0.01% w/w)

• Rs. 199/-
 ADVERSE EFFECT
• Irritation Most common
other adverse effects –
•erythema, stinging, irritant and allergic contact dermatitis, nail
discoloration, transient hypochromia.
•The so-called confetti-like depigmentation or guttate hypomelanosis is
characterized by mottled depigmented spots that develop on the macules of
melasma.
•Exogenous ochronosis a blue-black pigmentation of the treated areas, has
been mainly reported in darker skin from prolonged use of a strong
concentration.
 MONOBENZYL ETHER OF HYDROQUINONE
• monobenzyl ether of hydroquinone should be used exclusively in persons with
extensive vitiligo who have decided to totally depigment their skin.

• MBEH is available as a 20% cream, although it may be formulated up to 40% for

difficult areas such as the elbows and knees.
 MERCURY
• Mercury compounds have been used
with varying success to lighten skin
pigment.

• Mercury exists in three forms:

elemental, inorganic and organic.

• The inorganic form of mercury may be

an added ingredient in cosmetic.
• FDA approved – 1ppm
• mercury ions replace the copper necessary for tyrosinase activity, thus inactivating
the enzyme and inhibiting melanin synthesis.

• mercury in bleaching creams has been banned because of percutaneous absorption

and potential nephrotoxicity.
 Azelaic Acid
• Dicarboxylic acid isolated from Pityrosporum ovale

• 15-20% concentrations as efficient as HQ

• Less of an irritant

• Significantly greater decreases in pigmentary intensity

• Side effects are mild and temporary- pruritus, erythema, scaling and
irritation
 TOPICAL CORTICOSTEROIDS
• Topical corticosteroids lighten the skin by the following mechanisms-
• Initial blanching due to vasoconstriction
• Slowing down skin cell turnover so reducing the number and activity
of melanocytes (pigment cells)
• Reducing production of precursor steroid hormones thus reducing production
of melanocyte stimulating hormone (MSH).
 ASCORBIC ACID
• Antioxidant properties and affects melanogenesis by reducing dopaquinone to DOPA
and preventing free-radical production and absorption of ultraviolet radiation.
• Vitamin C may also chelate copper ions thus blocking tyrosinase activity.
• The advantage of 5% topical preparation is almost nil side effects.
 HYDROGEN PEROXIDE
• bleaching human hair is a partial or complete oxidative degradation of the natural
color pigment.
• the hair protein is also attacked by the treatment reagents
• since the melanin granules are mainly within the cortex of the fibers, suitable
treatment result in oxidative modification of the cuticle proteins and the cortex
proteins as well.
• This is often referred to as bleaching or oxidative damage.
• The bleaching reagents most often utilized are aqueous solutions of hydrogen
peroxide adjusted to pH values between 9 and 11.

• the bleaching reaction occurs in two steps:

• 1)The initial solubilization of the granules
• 2)decolorization of the dark brown solubilized pigment.

• solubilization of the granules is connected with the splitting of disulfide bridges in

the melanoprotein.
 POTASSIUM PERSULFATE
• Potassium Persulfate is used in Bleach Powders, Bleaching Creams and hair
lighteners where it helps during application to decolorize or lighten the hair by
oxidizing the colors present in the hair shaft.
• It also accelerates the bleaching process of peroxide hair bleaches.
THANK YOU