4-Hydroxyanisole-Tretinoin Formulation

• The addition of 0.01% tretinoin to 4-OHA is shown by several studies to significantly enhance the skin depigmenting effect of 4-OHA.
• This combination is a very potent skin depigmenting formula and is used for the treatment of liver spots (senile lentigo). Liver spots are usually very resistant to depigmenting agents and are very hard to treat. Most likely, this formula serves as the most effective topical treatment for this hyperpigmentary disorder. 4-OHA-tretinoin is also shown to depigment the normal skin surrounding the vitiligo lesions and therefore may be used as an alternative to benoquin in patients with extensive vitiligo.
• Whether 4-OHA-tretinoin can also be used for skin whitening in normal individuals is not well studied.
• Therefore, the possibility of serious side effects such as non-uniform skin depigmentation is not ruled out.
• 4-OHA-tretinoin should be applied once to twice daily to the dark spots, without touching the surrounding normal skin. It may take several weeks until the liver spots begin to depigment and the treatment should be continued to prevent repigmentation.
• Q-switched ruby laser serves as an alternative for the treatment of liver spots.

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