A new formula for depigmenting human skin

Kligman, A.M.

doi:10.1001/archderm.111.1.40

Cited by 196 publications

(216 citation statements)

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“…Tretinoin alone is known to reduce pigmentation of melasma (Pathak et al1986). A mixture cream of tretinoin, hydroquinone and dexamethasone was found to be more effective in the depigmentation (Kligman and Willis 1975). In our study, however, a mixture of tretinoin and hydrocortisone lactate only was not effective to melasma of the Japanese, suggesting that hydroquinone might be prerequisite to decrease pigmentation of melasma.…”

Section: Discussioncontrasting

confidence: 73%

The Effect of Topical Tretinoin on the Photodamaged Skin of the Japanese.

Tadaki

Watanabe

Kumasaka

et al. 1993

Tohoku J. Exp. Med.

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Section: Discussioncontrasting

confidence: 73%

The Effect of Topical Tretinoin on the Photodamaged Skin of the Japanese.

Tadaki

Watanabe

Kumasaka

et al. 1993

Tohoku J. Exp. Med.

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“…After a preliminary trial with a small number of cases, Klingman et al [10] reported that increasing the concentration of tretinoin to 0.2% accentuated irritation without a corresponding gain in effectiveness. In a recent study, Griffiths et al [7] also claimed that atRA at 0.1 and 0.025% produced similar clinical and histologic changes in patients with photoaging, despite the significantly greater incidence of irritation with the higher concentration.…”

Section: Discussionmentioning

confidence: 99%

“…In order to reduce undesirable side effects such as erythema and irritation and with the expectation of a synergistic depigmenting effect, topical application of corticosteroid has been recommended and widely performed [4,10]. However, Pathak et al [18] indicated that corticosteroids are not essential in depigmenting formulations.…”

Section: Discussionmentioning

confidence: 99%

“…Since Kligman et al [10] reported that the combined use of topical atRA, dexamethasone, and hydroquinone was more effective as a depigmenting formulation than a single use of each reagent, hydroquinone has been widely used in combination with atRA and corticosteroid [4,18]. Furthermore, in recent years, hydroquinone has been used in combination with laser therapies [1,2,8], dermabrasion [20], and chemical peelings such as Jessner's solution and glycolic acid [3,5,13,14].…”

mentioning

confidence: 99%

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A New Bleaching Protocol for Hyperpigmented Skin Lesions with a High Concentration of All-trans Retinoic Acid Aqueous Gel

Harii¹,

Aoyama²,

Shibuya³

et al. 1999

Aesthetic Plastic Surgery

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Abstract.A new bleaching protocol for skin hyperpigmentation with a higher concentration of all-trans retinoic acid (atRA) aqueous gel than those commercially available is introduced. AtRA aqueous gel (0.1%) was applied topically twice a day along with 4% hydroquinone, 7% lactic acid ointment to oriental patients with hyperpigmented lesions such as senile lentigines, melasma, and postinflammatory hyperpigmentation. The clinical results of 39 patients treated with 0.1% atRA aqueous gel were compared to those of 22 patients treated with 0.1% atRA hydrophilic ointment. Better clinical results and subjective satisfaction were obtained through a significantly shorter period of treatment with 0.1% atRA aqueous gel than with 0.1% atRA hydrophilic ointment, although side effects such as erythema and irritation were seen at a higher frequency. It is suggested that our bleaching protocol with a high concentration of atRA aqueous gel in combination with hydroquinone and lactic acid has a strong bleaching ability and a potential as a standard therapy for various kinds of skin lesions with hyperpigmentation.

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“…The classical combination, termed Kligman's formula consists of a bleaching agent (hydroquinone 5%), an exfoliating agent (tretinoin 0.1%) and topical steroid (dexamethasone). Topical steroids are not only antiinflammatory; they also inhibit melanocyte activity [15]. Other combinations and modifications on the original Kligman's formula have been developed over the years using different ingredients and/or different concentrations of ingredients.…”

Section: Preparations That Inhibit Melanin Production and Transfermentioning

confidence: 99%

Melasma, Novel Treatment Modalities

Abdallah¹

2014

Pigmentary Disorders

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Treatment of melasma remains challenging due to frequent relapses and the occurrence of post-inflammatory hyperpigmentation (PIH) following many interventions. Treatment goals are inhibition of melanin synthesis and transfer by sunscreens, sun avoidance and the use of bleaching agents on one hand and removal of already present pigment by peeling, lasers and light on the other hand. Triple combination creams (TCC) (also known as Kligman's formula utilizing hydroquinone and modifications of Kligman's formula) remain the mainstay of treatment. Newer bleaching agents derived from plants and synthetic compounds have been introduced and many of them are promising safe substitutes for hydroquinone.Peeling agents especially superficial and medium depth peels are effective treatment modalities for melasma. Newer peeling agents are less irritating and may thus lead to fewer side effects. Q-switched lasers, which target melanin, have led to PIH until the innovation of "laser toning" and fractional Qswitched ruby, which have better outcomes. Fractional non-ablative and ablative lasers are useful at lower fluencies. Pulsed dye laser, which targets the vascular component in melasma, is promising with less melasma rebound.Combinations of the above-mentioned modalities usually have a better treatment outcome than either alone. This review will focus on the more recently introduced therapies.

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A new formula for depigmenting human skin

Cited by 196 publications

References 0 publications

The Effect of Topical Tretinoin on the Photodamaged Skin of the Japanese.

The Effect of Topical Tretinoin on the Photodamaged Skin of the Japanese.

A New Bleaching Protocol for Hyperpigmented Skin Lesions with a High Concentration of All-trans Retinoic Acid Aqueous Gel

Melasma, Novel Treatment Modalities

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