Evaluation of a Prescription Strength 4% Hydroquinone/10% L-Ascorbic Acid Treatment System for Normal to Oily Skin

December 2011 | Volume 10 | Issue 12 | Original Article | 1455 | Copyright © December 2011


Suzanne Bruce MDa and JoAnne Watson DPMb

aSuzanne Bruce and Associates, PA, Houston, TX bOMP, Inc., Long Beach, CA

Abstract
Introduction: A 4% hydroquinone/10% L-ascorbic acid treatment system aims to treat early signs of photodamage in normal to oily skin and help prevent further photodamage. The system also contains vitamin E, witch hazel, aloe barbadensis leaf juice, penetration-enhancing ingredients, micronized zinc oxide, and octinoxate.
Methods: Patients with minimal or mild facial photodamage and hyperpigmentation, and normal to oily facial skin, used the treatment system for 12 weeks.
Results: Of 34 females enrolled, 30 completed. Median scores for the overall integrated assessment of photodamage, overall intensity of pigmentation, fine lines and wrinkles, tactile roughness, and laxity were significantly improved at week 12 compared with baseline. Furthermore, ≥90 percent of patients considered their skin was smoother, softer, more evenly toned, and more radiant, and 100 percent were satisfied with the overall appearance of their skin.
Conclusion: The treatment system can help to ameliorate early signs of photodamage in normal to oily skin.

J Drugs Dermatol. 2011;10(12):1455-1461.

INTRODUCTION

Photodamage is a cumulative process and is best minimized or, ideally, prevented. Protecting the skin from ultraviolet light is the simplest and most effective method of preventing photodamage, but other approaches, such as the use of antioxidants, may also offer benefit. For skin that is already photodamaged, early intervention is advised not only to improve the appearance of the skin but also to encourage the adoption of adequate sun protection measures at a young age-thereby hopefully minimizing the need for further intervention later.
A variety of agents are used to reduce the manifestations of photodamage, including hydroquinone and L-ascorbic acid. An early intervention system containing prescription strength (4%) hydroquinone and 10% L-ascorbic acid has been developed to treat photodamage in youthful looking skin and prevent the development of further photodamage. The original version of this physician-dispensed early intervention system was designed for normal to dry skin and, more recently, a second version of the system has been developed for normal to oily skin.
A clinical study has been performed to evaluate the efficacy of this newer version of the 4% hydroquinone/10% L-ascorbic acid treatment system in individuals with normal to oily skin.

METHODS

Patients

Individuals were eligible for enrollment into this study if they had the following: a clinical diagnosis of minimal or mild facial photodamage and hyperpigmentation; type I or II Glogau photodamage classification; and a score of 1, 2, or 3 on the overall integrated assessment of facial photodamage and the overall intensity of facial pigmentation scale (Table 1). They were also required to have normal to oily facial skin and be between 18 and 40 years old. Newspaper advertisements approved by the institutional review board were used to recruit patients into the study.
Participants were required to refrain from the following during the study: the facial use of non-study topical products (including medications, moisturizers, sunscreens, and fragrances); the facial use of medicated make-up (except oil-free non-comedogenic make-up, mascara, eyeliner, eyeshadow, and lipstick were allowed if they were already being used before the study); facial procedures (including peels, facials, microdermabrasion, and injection of botulinum toxin type A or dermal fillers); and removal of facial hair (except plucking of eyebrows with tweezers was allowed). They were also required to be willing to avoid excessive sun exposure and refrain from using tanning booths.