While lightening treatments like tranexamic acid cream are gaining in popularity, hydroquinone remains the standard treatment for hyperpigmentation of various causes. Certain over-the-counter products like Porcelana cream contain hydroquinone in low concentrations – usually around 2%. The higher concentration creams with 6%, 8%, or 10% hydroquinone in combination with other ingredients can only be obtained from a compounding pharmacy. In addition, a compounding pharmacy can make customized creams with several active ingredients combined to better treat hyperpigmentation. A good example of this is a hydroquinone, tretinoin, corticosteroid cream, which is a first-line treatment for hyperpigmentation.
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Combination Hydroquinone and Tretinoin Creams
Hydroquinone with tretinoin and a corticosteroid is the most commonly prepared combination skin lightening cream. Triamcinolone acetonide and hydrocortisone are two examples of corticosteroids that may be included to help reduce redness, itchiness, and swelling. This type of ingredient is almost essential when prescribing higher strength combinations of hydroquinone with other active ingredients.
Cdpedia 6 0 1 Hydrocortisone Cream Uses
Hydroquinone is atyrosinase inhibitor that is sometimes called a “bleaching” or “brightening”agent. Used on its own, hydroquinone is effective, but not as effective as whenit is combined with tretinoin. Hydroquinone’s brightening effects arereversible. This means that once treatment is discontinued, a trigger like sunexposure can reactivate the hyperpigmentation.
Tretinoin, alsosometimes called retinoic acid, is a vitamin A derivative that has been shownto be an effective treatment for hyperpigmentation.
![Cdpedia 6 0 1 hydrocortisone cream usp Cdpedia 6 0 1 hydrocortisone cream usp](https://www.dailymed.nlm.nih.gov/dailymed/image.cfm?name=CR-1139+Hydrocortisone+Cream+PDP2.jpg&id=416233)
5 Uses of Hydrocortisone Cream for Dogs. Remedy & Recovery Hydrocortisone Lotion for Dogs (0.5%) Find it on Amazon. When applied directly to the skin after a soothing bath or gentle rinsing of. Hydrocortisone (Hydrocortisone Cream and Ointment 2.5%) may treat, side effects, dosage, drug interactions, warnings, patient labeling, reviews, and related medications including drug comparison and health resources. About hydrocortisone skin creams. Hydrocortisone creams, ointments and lotions contain a type of. Drugstore hydrocortisone is often the first treatment for eczema. Choosing the right cortisone cream or lotion may be nearly as puzzling as finding out what causes. Usually 0.5 and 1. Although Dioderm ® contains only 0.1% hydrocortisone, the formulation is designed to provide a clinical activity comparable to that of Hydrocortisone Cream 1% BP. In children The RCPCH and NPPG recommend that, when a liquid special of hydrocortisone is.
Hydrocortisone,triamcinolone, and other corticosteroids are used to help reduce inflammationthat may occur when skin lightening agents are used.
What Are These Combination Creams Used For?
Combination skin lightening creams are used for treatingvarious types of hyperpigmentation.
Melasma, forexample, is a type of hyperpigmentation affecting the face in a symmetricalpattern. It is most common in women, especially those who are pregnant. It istriggered by sun exposure and sometimes hormonal changes. A skin lighteningcream can help even skin tone to reduce the appearance of melasma.
Age spots, alsocalled sun spots, are another type of hyperpigmentation. These dark spots onthe skin occur when excess melanin is produced following exposure to UVradiation. In most cases it takes years of sun exposure to develop these spotsbut they can appear on anyone. Another word for hyperpigmentation changes dueto UV radiation is “photodamage.” Photodamaged skin is one of the main reasonspatients seek treatment with a combination lightening cream.
Post-inflammatoryhyperpigmentation (PIH) is a discoloration resulting from injury or a skincondition. For example, patients with acne will often develop scarring along withdarkened or reddish areas of hyperpigmentation. PIH can be the last reminder ofacne even after flare-ups are completely under control. The term “cosmetic” inthese types of cases can sometimes seem like a derogatory term. While PIH afteracne does not necessarily cause any health issues for the skin, it can cause significantemotional distress. If a lightening cream can help reduce the appearance of PIHfor a patient it can often improve their quality of life. This is true as wellfor melasma and age spots.
How is A Hydroquinone Tretinoin Cream Used?
It can take at least 4 weeks and even up to 8-12 weeks tonotice results from using a hydroquinone tretinoin cream. Application is oftendone once daily at bedtime. A broad-spectrum sunscreen is recommended for dailyuse as well. Many patients will experience mild side effects like redness anditching. While more severe side effects are possible, they are not common. Treatmentwith these creams continues for a length of time determined by the patient’sdermatologist. Regular checkups help make sure the treatment is working andthat there are no adverse effects.
In studies of hydroquinone and tretinoin, patientsatisfaction rates have been high. A study in the Journal of Drugs inDermatology with hydroquinone 4% and tretinoin showed that at week 24, 87.9% ofpatients were “satisfied” or “very satisfied” with their treatment. For higherstrengths of hydroquinone, continuing treatment for two years may not bepossible for all patients. Some doctors will use treatment courses lasting 3-6months, with time in between treatment courses to allow the skin to adjust. Othersmay prescribe the cream to be used only two or three times a week.
Triple ingredient lightening creams can take time to work, so it is important for patients not to get discouraged if they do not see the results they want after a month of treatment. The skin needs time to replace the hyperpigmented skin cells with new skin cells for the results to be visible.
Example Formulations
Hydroquinone | Tretinoin | Hydrocortisone | Kojic Acid | |
Compound 1 | 6% | 0.05% | 0.5% | |
Compound 2 | 8% | 0.1% | 0.5% | |
Compound 3 | 6% | 0.05% | 0.5% | 4% |
Compound 4 | 8% | 0.05% | 0.5% | 4% |
Sun Protection
Using a hydroquinone tretinoin cream makes your skin moresensitive to the sun. While melanin is inhibited, the skin is less protectedfrom UV rays. Proper sun protection involves staying out of the sun when thesun is at its peak (usually between 10am – 4pm), wearing a sun hat, andregularly applying broad-spectrum sunscreen with an SPF of 30 or higher when outside.Some of the worst side effects of a hydroquinone cream occur when the sun isnot protected from sun exposure. If you are using a hydroquinone tretinoincream and notice swelling, crusting, or an allergic reaction, you shouldcontact your healthcare provider immediately.
Alternatives for Skin Lightening
One of the reasons that hydroquinone tretinoin creams arepopular for skin lightening is that they are cost effective. It has been inshown in some studies that hydroquinone combined with laser therapy can getfaster results than when it is used alone. Laser therapy is expensive, though,as are other in-office treatments for hyperpigmentation. Some patients may wantto use everything that their dermatologist has available including lasers,chemical peels, creams, and other treatments. However many patients will accepta slightly longer treatment time with a lower cost and no downtime.
Articles
Melasma and Post Inflammatory Hyperpigmentation: Management Update and Expert Opinion – Skin Therapy Letter (PubMed)
Rocket typist pro 2 1 20. Combination of Hydroquinone and Fractional CO2 Laser versus Hydroquinone Monotherapy in Melasma Treatment: A Randomized, Single-blinded, Split-face Clinical Trial. – Indian Journal of Dermatology (PubMed)
Class | Potency | Generic Name and Strength | Brand Name and Formulation |
Class 1 | Super Potent | Augmented Betamethasone Dipropionate 0.05% | Diprolene Ointment / Lotion |
Clobetasol Propionate 0.05% | Temovate E Cream Temovate Cream / Ointment Olux Foam Clobex Spray / Lotion / Shampoo | ||
Fluocinonide 0.1% | Vanos Cream | ||
Halobetasol Propionate 0.05% | Ultravate Cream / Ointment | ||
Class 2 | Potent | Amcinonide 0.1% | Generic Amcinonide Ointment |
Augmented Betamethasone Dipropionate 0.05% | Diprolene AF Cream | ||
Desoximetasone 0.25% | Topicort Cream / Ointment | ||
Desoximetasone 0.05% | Topicort Gel | ||
Diflorasone Diacetate 0.05% | ApexiCon E Cream | ||
Fluocinonide 0.05% | Generic Fluocinonide Cream / Ointment | ||
Halcinonide 0.1% | Halog Cream / Ointment | ||
Mometasone Furoate 0.1% | Elocon Ointment | ||
Triamcinolone Acetonide 0.5% | Generic Triamcinolone Acetonide Ointment | ||
Class 3 | Upper Mid-Strength | Betamethasone Dipropionate 0.05% | Generic Betamethasone Dipropionate Cream |
Betamethasone Valerate 0.1% | Generic Betamethasone Valerate Ointment | ||
Fluticasone Propionate 0.005% | Generic Fluticasone Propionate Ointment | ||
Triamcinolone Acetonide 0.5% | Generic Triamcinolone Acetonide Cream | ||
Class 4 | Mid-Strength | Clocortolone Pivalate 0.1% | Cloderm Cream |
Fluocinolone Acetonide 0.025% | Synalar Ointment | ||
Flurandrenolide 0.05% | Cordran Ointment | ||
Hydrocortisone Valerate 0.2% | Westcort Ointment | ||
Mometasone Furoate 0.1% | Elocon Cream / Lotion | ||
Class 5 | Lower Mid-Strength | Betamethasone Dipropionate 0.05% | Generic Betamethasone Dipropionate Lotion |
Betamethasone Valerate 0.1% | Generic Betamethasone Valerate Cream | ||
Desonide 0.05% | DesOwen Ointment | ||
Fluocinolone Acetonide 0.025% | Synalar Cream | ||
Flurandrenolide 0.05% | Cordran Cream / Lotion | ||
Fluticasone Propionate 0.05% | Cutivate Cream | ||
Hydrocortisone Butyrate 0.1% | Locoid Cream / Ointment / Solution | ||
Hydrocortisone Valerate 0.2% | Westcort Cream | ||
Prednicarbate 0.1% | Dermatop Cream | ||
Class 6 | Mild | Alclometasone Dipropionate 0.05% | Aclovate Cream / Ointment |
Desonide 0.05% | Verdeso Foam DesOwen Cream / Lotion | ||
Fluocinolone Acetonide 0.01% | Synalar Cream / Solution | ||
Class 7 | Least Potent | Hydrocortisone 0.5 / 1% / 2.5% | Generic Hydrocortisone Cream / Ointment / Lotion |
Cdpedia 6 0 1 Hydrocortisone Cream 1%
Notes
This list is not exhaustive.
Generic and brand name data from:
Cdpedia 6 0 1 Hydrocortisone Cream Usp
1. Jacob SE, Steele T. Corticosteroid classes: A quick reference guide including patch test substances and cross-reactivity. J Am Acad Dermatol. 2006;54(4):723-727.
Cdpedia 6 0 1 Hydrocortisone Cream 2%
2. Package Inserts.