Med Dallas

Skin Care

Melasma HQ Cream / Skin Lightening Cream

Melasma HQ Cream is a specialized topical formulation designed to address hyperpigmentation issues such as melasma, freckles, and lentigines. This cream combines a potent blend of active ingredients—hydroquinone, tretinoin, kojic acid, and hydrocortisone—to target and lighten unwanted pigmentation, improve skin texture, and manage inflammation. By inhibiting melanin production and promoting skin cell turnover, Melasma HQ Cream helps restore a more even and radiant complexion. It is essential to use this cream in conjunction with sun protection to prevent further pigmentation and achieve optimal results.

Hydroquinone

Function

Topical depigmenting agent used to lighten hyperpigmented skin conditions like melasma, freckles, and lentigines. It works by inhibiting melanin production.

Considerations

Reversibility: Unlike monobenzone, the depigmentation caused by hydroquinone is reversible. Sun Protection: Sunscreens should be used in conjunction with hydroquinone to prevent further pigmentation. History: Available since before 1938 and used in various applications, including as an antioxidant and in photographic development.

Use

Typically applied to affected areas to reduce pigmentation.

Tretinoin

Function

A derivative of vitamin A, it regulates cell reproduction, proliferation, and differentiation. Used topically for acne, photodamaged skin, and keratinization disorders.

Considerations

Side Effects: Can cause acute promyelocytic leukemia differentiation syndrome in some patients. Mechanism: Helps in reducing acne and improving skin texture by promoting cell turnover and differentiation.

Use

Topical: For acne, photodamage, ichthyosis, and keratosis pilaris. Oral: Used for treating acute promyelocytic leukemia (APL) and being investigated for Kaposi’s sarcoma.

Kojic Acid

Function

A chelation agent that inhibits melanin production, used to lighten skin and preserve or change colors in foods and cosmetics.

Source

Produced by fungi, notably Aspergillus oryzae, used in sake production.

Use

As a mild skin-lightening agent in cosmetic products.

Hydrocortisone

Function

A naturally occurring steroid hormone with glucocorticoid and mineralocorticoid activity. Used for its anti-inflammatory and immunosuppressive effects.

Considerations

Systemic hydrocortisone is less commonly used for asthma compared to other corticosteroids like prednisone. Topical forms are preferred for localized inflammatory conditions.

Use

Systemic: For adrenal insufficiency, allergic, immune, and inflammatory conditions. Topical: For mild to moderate dermatoses. Low-potency forms are used safely for chronic conditions, including on the face and in children.

Forms

Available in rectal, parenteral, oral, and topical forms.

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Effective Depigmenting Agent

Hydroquinone is a key component of Melasma HQ Cream, renowned for its ability to lighten hyperpigmented skin. It works by inhibiting the enzymatic oxidation of tyrosine, a crucial step in melanin production.

Promotes Skin Cell Turnover

Tretinoin, a derivative of vitamin A, enhances the effectiveness of Melasma HQ Cream by regulating cell reproduction and differentiation. It aids in reducing acne, improving skin texture, and treating photodamaged skin.

Chelation Agent for Skin Lightening

Kojic acid is included in Melasma HQ Cream for its ability to inhibit melanin production through chelation. This naturally occurring compound, produced by fungi such as Aspergillus oryzae, helps lighten skin and prevent further discoloration.

Product Overview

5/5

Dosage Strengths

Nourishes deeply
1
Reduces blemishes
2
Enhances glow
3

More Details About Product

  • Hydroquinone
    • Primary Mechanism: Inhibits melanin production by blocking the enzymatic oxidation of tyrosine to 3,4-dihydroxyphenylalanine (DOPA) in melanocytes, reducing pigmentation.
    • Effect of Sunlight: Exposure to sunlight or UV light can cause repigmentation of previously lightened areas by stimulating melanocytes to produce melanin again.
  • Tretinoin
    • Retinoid Receptors: Acts through binding to retinoic acid receptors (RARs) rather than retinoid X receptors (RXRs). Interacts with all three types of RARs (alpha, beta, gamma). RAR-alpha and RAR-beta are associated with certain cancers; RAR-gamma affects mucocutaneous tissues and bone.
    • Skin Disorders: Increases epidermal cell turnover, reduces horny cell cohesion, and promotes expulsion of comedones. Reduces fine wrinkling and hyperpigmentation by inhibiting matrix metalloproteinases (collagenase, gelatinase, stromelysin-1), which degrade collagen.
    • Acute Promyelocytic Leukemia (APL): Induces differentiation in malignant cells by altering the activity of the PML-RAR-alpha fusion protein, promoting differentiation and maturation of APL cells.
  • Kojic Acid
    • Primary Mechanism: Inhibits tyrosinase, an enzyme crucial for melanin production, leading to lighter skin by decreasing pigment formation.
  • Hydrocortisone
    • Anti-inflammatory Effects: Induces lipocortins that inhibit phospholipase A2, reducing the release of arachidonic acid and inflammatory mediators like prostaglandins, histamines, and kinins. Reduces inflammation, edema, erythema, pruritus, and scaling by decreasing macrophage and leukocyte activity and reversing vascular dilation and permeability.
    • Additional Actions: Inhibits allergic response mediators and suppresses inflammatory processes. Improves long-term asthma control by reducing bronchial hyperresponsiveness and symptoms.
  • Hydroquinone
    • Contraindications:
      • Hypersensitivity: Avoid use in patients with a history of hypersensitivity to hydroquinone, parabens, sulfites, or any other ingredient in the product.
      • Skin Conditions: Do not use on irritated, damaged, or sunburned skin, or on areas with skin abrasions.
    • Precautions:
      • Sun Exposure: High concentrations or prolonged use can lead to hyperpigmentation, particularly with sunlight exposure. Use sunscreen to mitigate this risk.
      • Pregnancy: Safety during pregnancy has not been established; use only if clearly needed.
      • Breastfeeding: Potential for excretion in breast milk is unknown; use cautiously and consider risks vs. benefits.
      • Children: Safety in children under 12 has not been established.
  • Tretinoin
    • Contraindications:
      • Hypersensitivity: Avoid in patients with retinoid hypersensitivity or cross-sensitivity to vitamin A or other retinoids.
      • Fish Allergy: Brands containing fish proteins (e.g., Atralin, Altreno) should be used cautiously in patients with fish allergies.
    • Precautions:
      • Differentiation Syndrome: Monitor for acute promyelocytic leukemia differentiation syndrome (RA-APL syndrome), especially with high leukocyte counts.
      • Photosensitivity: Tretinoin can cause photosensitivity. Avoid sun exposure or use sunscreen and protective clothing. Do not use on sunburned skin.
      • Eczema: Avoid use in patients with eczema due to risk of severe irritation.
      • Children: Safety and efficacy in children under 12 have not been established; use cautiously and consider the risk of pseudotumor cerebri with oral forms.
      • Ocular Exposure: Avoid contact with eyes and mucous membranes. If contact occurs, rinse thoroughly with water.
      • Flammability: Tretinoin is flammable; avoid use near heat or open flame.
  • Hydrocortisone
    • Contraindications:
      • Cushing’s Syndrome: Avoid in patients with Cushing’s syndrome.
      • Active Infections: Avoid use in the presence of active infections, including tuberculosis, dermatologic fungal infections, and viral infections.
      • Hypersensitivity: Rare but possible hypersensitivity reactions; use with caution in those with known hypersensitivity to corticosteroids.
    • Precautions:
      • Systemic Absorption: Prolonged use or use over large areas can lead to systemic absorption and HPA axis suppression. Monitor for symptoms of Cushing’s syndrome.
      • Pediatric Use: Chronic use in children can interfere with growth. Use the lowest effective dose and avoid occlusive diapers.
      • Pheochromocytoma: Caution in patients with suspected pheochromocytoma due to risk of pheochromocytoma crisis.
      • Glaucoma & Cataracts: Avoid ocular exposure due to risk of cataracts and glaucoma. Periodically assess for these conditions in long-term users.
      • Skin Atrophy: Avoid use on pre-existing skin atrophy. Use lower-potency corticosteroids in sensitive areas or elderly patients.
  • Hydroquinone

    • Common Adverse Reactions: Skin irritation (burning, erythema, stinging), sensitization, contact dermatitis.
    • High Concentration Effects: Skin hyperpigmentation, especially with sunlight exposure.
    • Serious Adverse Reactions: Exogenous ochronosis (blue-black skin discoloration), which may be irreversible. Risk of irritation in sensitive areas like paranasal and infraorbital regions.
    • Other Effects: Corneal staining if applied to the eye, bitter taste and anesthetic effect on lips, reversible brown nail discoloration.

    Tretinoin

    • Topical Therapy: Common reactions include skin irritation (peeling, dry skin, burning, stinging, erythema, pruritus). Severe irritation in about 32% of patients may require temporary discontinuation or corticosteroid use.
    • Systemic Therapy: Reported adverse reactions include dry skin/mucous membranes, rash, pruritus, alopecia, cellulitis, and emotional changes. Photosensitivity is common; sunscreen use is recommended.
    • Serious Reactions: Skin hyperpigmentation and hypopigmentation, increased risk of photosensitivity.

    Kojic Acid

    • Common Adverse Reactions: Contact dermatitis, irritation, rashes, inflamed skin, itchiness, and pain, especially at concentrations >1%. Potential for sunburn in sensitive skin areas.

    Hydrocortisone

    • Systemic Reactions: Prolonged use can lead to HPA axis suppression, secondary adrenal insufficiency, withdrawal syndrome, and potential for serious conditions like Cushing’s syndrome, diabetes, hypertension, and cardiovascular issues.
    • Topical Reactions: Skin irritation (burning, pruritus, xerosis), folliculitis, acneiform rash, skin atrophy, and secondary infections. Long-term use can cause ocular issues like cataracts and glaucoma.
    • Other Effects: Systemic absorption risks, tolerance development, allergic contact dermatitis, dizziness, anemia, and vitamin deficiencies.

    Hydroquinone

    • Pregnancy: Safety during pregnancy has not been established. Animal studies are lacking, and systemic absorption is unknown. Use only if clearly needed.
    • Breastfeeding: It is not known if hydroquinone is excreted in breast milk. Caution is advised. The low molecular weight suggests potential passage into milk, but the ionized state may reduce availability for excretion. Balance the benefits of breastfeeding with potential risks.

    Tretinoin

    • Pregnancy: Use is not recommended due to potential risks. Oral tretinoin is highly teratogenic and requires strict contraceptive measures and pregnancy testing before and during treatment. Topical tretinoin should be used cautiously and avoided on large areas.
    • Breastfeeding: Oral tretinoin should not be used while breastfeeding. Topical tretinoin has low systemic absorption, but caution is advised. Alternative topical agents might be considered. Evaluate the benefits of breastfeeding against potential risks.

    Kojic Acid

    • Pregnancy: Safety during pregnancy is not well-established. Use may not be recommended due to insufficient data on fetal risk.
    • Breastfeeding: It is unknown if kojic acid is absorbed or excreted in breast milk. Caution is advised when used by breastfeeding mothers.

    Hydrocortisone

    • Pregnancy: Systemic and rectal hydrocortisone use requires caution due to potential teratogenic effects observed in animals. Topical use is generally safer but should be limited to mild to moderate potency and used for short durations. Large amounts or prolonged use can lead to risks such as fetal growth restriction.
    • Breastfeeding: Systemic hydrocortisone use during breastfeeding has not been studied extensively, but cortisol is naturally present in breast milk. Topical hydrocortisone is generally considered safe, though care should be taken to prevent the infant from direct contact with the application site.
    Store this medication in its original container at 68°F to 77°F (20°C to 25°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.