Available Dosage Strengths
6% / 2.5% / 0.05%
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Skin lightening (brighteners) therapy is used to treat skin conditions that emanate from hyperpigmentation. Melanin, a pigment that causes skin darkening, is synthesized within melanocytes from thyrosine facilitated by the enzyme tyrosinase. Melanin after being synthesized is moved to keratinocytes (the primary epidermal cells). Pigmentation occurs when more melanin is produced than normal or distributed in an abnormal pattern. Chemical products are used to decrease the hyperpigmentation that arises from melanin hyperproduction or abnormal distribution. Hydroquinone_Hydrocortisone_Tretinoin cream is a combination depigmentation or skin lightening agent used to treat melasma, chloasma, solar lentigines, freckles and post-inflammatory.1,2 hyperpigmentation.
Hydroquinone3,4
Hydroquinone, a phenolic, organic compound, has the molecular formula C6H6O2. It has been used in the photography industry along with the cosmetic industry. There is sound evidence to support its use as a skin-lightening agent. It is generally compounded in concentrations from 2% to 12%. The efficacy and toxicity of hydroquinone are contingent on its final concentration, the vehicle that hydroquinone is in and the chemical stability of the product. The benefits of hydroquinone as a skin-lightening agent may take up to 2 months.
Hydrocortisone5-8
Hydrocortisone, a steroid hormone that systematically has both glucocorticoid and mineralocorticoid activity, is the synthetic form of cortisol. Cortisol is a hormone produced by the adrenal glands. Hydrocortisone topically has anti-inflammatory, antipruritic, anti-mitotic, and immunosuppressive properties. There are many topical steroids available on the market. Hydrocortisone is a low potency steroid. It is used in creams that use many products to treat hyperpigmentation since it may mitigate irritation that emanates from other ingredients in the cream.
Tretinoin7-10
Tretinoin, a naturally occurring derivative of vitamin A, is also called all-trans-retinoic acid. Retinoids may facilitate regulation of cell reproduction, cell proliferation and differentiation. For hyperpigmentation disorders, tretinoin prevents the transcription of the enzyme tyrosinase which minimizes melanogenesis.
Hydroquinone1-4
Hydroquinone affects the melanogenesis process by inhibiting tyrosinase. It also inhibits DNA and RNA synthesis and suppresses the formation of melanosomes. The ability of hydroquinone to affect the melanocyte metabolic process may lead to a decrease in the production of melanin.
Hydrocortisone5-7
The anti-inflammatory effects of topical hydrocortisone may occur through vasoconstriction. The vasoconstriction minimizes inflammatory mediators delivered to the inflamed area. Topical hydrocortisone may also inhibit the release of phospholipase A2, which reduces prostaglandins and leukotriene. Lastly, topical hydrocortisone inhibits DNA and transcription factors related to inflammation. It does this by increasing the expression of anti-inflammatory genes and indirectly inhibiting inflammatory transcription factors, such as NF-kB, to decrease the expression of pro-inflammatory genes.
Topical hydrocortisone may also have an anti-mitotic effect by decreasing epidermal mitosis mediated through an increase in lipocortin, an endogenous glucocorticoid-regulated protein.
Topical hydrocortisone may also inhibit humoral factors in the inflammatory response by suppressing immune cells from maturing, differentiating and proliferating.
It may also decrease irritation from hydroquinone and tretinoin.
Tretinoin8-10
Tretinoin prevents the transcription of the enzyme tyrosinase which minimizes melanogenesis. In addition, tretinoin decreases melanin transfer, increases cell turnover of keratinocytes and the permeability in the stratum corneum. In this way melanin is dispersed.
In addition to its other activity, tretinoin prevents hydroquinone oxidation and improves epidermal penetration of hydroquinone.
Common3-12
Serious3-12
Contraindications: 3-12
Precautions: 3-12
Store at 20–25°C (68–77°F) in a cool, dry place, protected from light and moisture. Keep container tightly closed.
This sheet is a summary. It may not cover all possible drug information about this product. Call your doctor for medical advice and/or about side effects. You may report side effects to the FDA at 1-800-FDA-1088. A Wells Pharmacy Network pharmacist will be happy to answer any questions. For consultation, please call 1-800-622-4510.
