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How to use pigmentation creams like hydroquinone and tretinoin correctly?

Aesthetic Medicine Skin, Hair & Nails

I was given modified Kligman’s cream for pigmentation. I understand that it contains hydroquinone, tretinoin, and hydrocortisone. I was also given Differin for acne. I would like to find out more about how I can use pigmentation creams most effectively. For example, cleanse - Differin gel - pigmentation cream - moisturiser every 3 days?

DOCTOR’S ANSWER (2)

I do face many patients like yourself with similar questions regarding how to use topical medication creams they are given.

Firstly, I believe it is important to obtain these creams from a doctor who is familiar with using them. Your doctor and/or clinic should be able to identify the type of pigmentation you have, whether they are sun spots (lentigo), melasma, post-inflammatory hyperpigmentation, or freckles, for example, and then prescribe you the appropriate medication cream, as not all pigmentation respond with equal efficacy to Kligman's formula. 

I note that you also mentioned you have acne. Personally, I prefer not to combine tretinoin and differin (adapalene) together at the same time as both are in the class of medication called "retinoids". Both tretinoin and differin may be used for anti-aging, pigmentation and acne. While there is no strict rule and I know of some patients who do well alternating these 2 creams daily, using both tretinoin and differin at the same time can increase your risk of skin dryness, redness, peeling and sun sensitivity. I would suggest you bring this up to your doctor, who may then assess which is your predominant issue and advise accordingly. 

Finally, I recommend all my patients to cleanse and moisturise their face daily as part of a basic skincare routine. Happy new year and hope your skin continues to improve! 

Best regards,

Dr. Joanna Chan

0 187 views 2 Jan 2019

Hi!

I am assuming you are using the modified Kligman's for acne marks/PIH?

Modified Kligman's was formulated specifically for treatment of melasma but it is sometimes used for PIH.

Do you apply differin to the whole face of just the oily T zone/problematic jawline region?Is your skin sensitive and dry? or oily?

I am going to make some assumptions here.

I am assuming you are using Differin gel every night to control your acne and the lightening cream for marks. I will also assume that you have normal skin.

In that case, you can do the following nightly.

1. Cleanser

2. Differin gel on acne/oily areas

3. Spot on lightening cream on marks (only)

4. Moisturiser

* use sunblock daily!!!

Note:

If you have dry skin, try reducing the differin to alternate nights.

Lightening cream has to be used daily for fast results. STOP if your skin turns red/starts peeling.

Lightening cream should not be used continuously for more than 6 months.

Best to consult a dr and follow up regularly!

Lastly, if you are using the modified kligman's for melasma, the advise given will be completely different!

Best regards

Dr Yanni

0 86 views 23 Jan 2019
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