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.
