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Discussion Starter #1
Doctor's usually prescribe one of these formulations for skin discoloration, melasma, mild vitiligo, and dark spots:

Kligman's formula consists of 5% hydroquinone (HQ), 0.1% tretinoin, and 0.1% dexamethasone in hydrophilic ointment. In a clinical study, this formula completely depigged black males in 5 weeks of regular twice a day use.

Pathak's formula consists of 2% HQ and 0.05-0.1% tretinoin. This formula is potent enough for discoloration and melasma.

Westerhof's formula consists of 4.7% N -acetylcysteine (NAC), 2% HQ, and 0.1% triamcinolonacetonide.



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THanks, LNL. Kligman's formula has worked wonders for many people with pigmentation issues. Kligman himself had expressed wonder at how much adding tretinoin improved results. The actual raw ingredients are relatively inexpensive too. I'd come across the claim that he had lightened ******* skin in 5 short weeks but I've never seen the actual published study. It would be interesting to see just what was meant by 'black skinned males' (could be anything from a Fitz 3- a Fitz 6) as well, exactly what qualified as 'depigmented'. Were they bleached like linens or were they a decidly lighter brown tone? Variations of his formula have been compounded with 10% HQ &, since Benoquin is no longer readily available in the west due to viscosity issues, 20% for final depigmentation in Black patients with vitiligo.

The last formulation is one I've seen but know nothing about. It doesn't seem like it would be as effective as Kligman's judging by the ingredients but working synergistically, it might be a very effective formulation indeed. What do you know about Westerhof's?
 

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Discussion Starter #5
I havent tried the Kligman's but ondine I had a friend 1 shade darker than you who was prescribed Kligman's for his acne and he went went 4 shades lighter in 2 months flat, I was amazed, his skin looked really shiny though, the thing that made the difference was the steroid and 5% HQ. The westerhoff's formula is supposed to be extremely effective and its used in african patients but they never really got into it.



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You are right LNL. The $80 compound that my derm wrote for me consisted of HQ 5%, HC 2%, RA 0.025% and Kojic Acid. .
 

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what were ur reasons for using the modified kligman? you mustve had good results. most dermatologists here in the US just blatantly ignore patients request even if they have noticeable hyperpigmentation/discolorations.



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Yes I did have good results. And yes you are right - most derms say they don't treat for skin lightening. However I was lucky and found a derm who saw my hands compared to the rest of my body and wrote the script.
My hands were severely sun damaged due to the lack of sunblock from previous skin lightening treatments many years ago- when I was able to lighten to the level I desired. Which is why I am a sunblock junkie now.
One of the treatments the derm used years ago was a compound similar to the one I used recently - minus the Kojic Acid.
 

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lol - I was just reading the "Clasife" thread where you, Reyaz and Crescent were discussing sunblocks. I use various SPF strengths of Neutrogena. As soon as I have used up all of those I plan on getting some of the LaRoche. I will be traveling to Canada soon - so I hope to pick some up then.
 

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Doctor's usually prescribe one of these formulations for skin discoloration, melasma, mild vitiligo, and dark spots:

Kligman's formula consists of 5% hydroquinone (HQ), 0.1% tretinoin, and 0.1% dexamethasone in hydrophilic ointment. In a clinical study, this formula completely depigged black males in 5 weeks of regular twice a day use.

Pathak's formula consists of 2% HQ and 0.05-0.1% tretinoin. This formula is potent enough for discoloration and melasma.

Westerhof's formula consists of 4.7% N -acetylcysteine (NAC), 2% HQ, and 0.1% triamcinolonacetonide.
Thanks for the post.. im wondering about this ingredient: 0.1% dexamethasone in hydrophilic ointment. Why have we exed this from the regimne and just do the HQ/RA?
 

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DM is used to mitigate the irritation some people get from RA. All patients do not need it & even Kligman doesn't automatically add it to his compound anymore having observed that the formulation is as effective at lightening w/o it & for those who do NOT get irritated from the RA 0.05% , why apply a steroid unnecessarily? ADC doesn't sell DM on its own. You can get a mild generic hydrocortisone cream at any pharmacy OTC. I keep a tube on hand for the rare mild irritation I might get in one or 2 spots from the RA 0.1% or the peels I've tried. A tiny dab zaps the problem almost instantly.

I've written to ASD for more details re their 'skinlite' with mometasone furoate. I want to see the %ages for all the actives. If it contains 4% HQ, 0.05% RA & MF in a small %age, it may be considered a modified Kligman's formula. If so, I'm definitely going to try it. If the HQ is only at 2%, it might be a good unevenness/melasma treatment for fair Asians & Caucasians. Either way, knowing would be good since more & more white people with this issue are joining up & looking for treatment options. I'll let you guys know as soon as ADC lets me know.
 

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I might have to check ADC for dexamethasone.
LNL,

Dexamethasone appears be one of the stronger topical Glucocorticoids.

When performing your search, it may be beneficial to look for the product in international markets by various trade names recognized in the associated country. For example, Thilodexine, Millicorten or Dexacortin.

Please note the links I've provided below:

http://www.egeneralmedical.com/rxlist00000883.html

http://goldpharma.com/?show=search&s...E&lang=ENGLISH

http://www.chemical4u.com/Millicortenol_-p-6730.html
 

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DM is used to mitigate the irritation some people get from RA. All patients do not need it & even Kligman doesn't automatically add it to his compound anymore having observed that the formulation is as effective at lightening w/o it & for those who do NOT get irritated from the RA 0.05% , why apply a steroid unnecessarily? ADC doesn't sell DM on its own. You can get a mild generic hydrocortisone cream at any pharmacy OTC. I keep a tube on hand for the rare mild irritation I might get in one or 2 spots from the RA 0.1% or the peels I've tried. A tiny dab zaps the problem almost instantly.

I've written to ASD for more details re their 'skinlite' with mometasone furoate. I want to see the %ages for all the actives. If it contains 4% HQ, 0.05% RA & MF in a small %age, it may be considered a modified Kligman's formula. If so, I'm definitely going to try it. If the HQ is only at 2%, it might be a good unevenness/melasma treatment for fair Asians & Caucasians. Either way, knowing would be good since more & more white people with this issue are joining up & looking for treatment options. I'll let you guys know as soon as ADC lets me know.
Mometasone furoate is a potent corticosteroid, albeit somewhat less potent than dexamethasone, but never the less still a steroid.

Mometasone furoate - Wikipedia, the free encyclopedia


While dexamethasone is used to treat irritation, its anti inflammatory properties are of the greatest benefit in reversing hyperpigmentation. There is a related study on hyperpigmentation and inflammation only it studies the use of histamine blockers and its action on H2 receptors. Inflammation is one of the key factors associated with over-hyperpigmentation (particularly post-injury hyperpigmentation) in individuals of darker skinned ethnicities.

Please refer to the link below for some background information.

Patent US6245795
 

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DM is used to mitigate the irritation some people get from RA. All patients do not need it & even Kligman doesn't automatically add it to his compound anymore having observed that the formulation is as effective at lightening w/o it & for those who do NOT get irritated from the RA 0.05% , why apply a steroid unnecessarily? ADC doesn't sell DM on its own. You can get a mild generic hydrocortisone cream at any pharmacy OTC. I keep a tube on hand for the rare mild irritation I might get in one or 2 spots from the RA 0.1% or the peels I've tried. A tiny dab zaps the problem almost instantly.

I've written to ASD for more details re their 'skinlite' with mometasone furoate. I want to see the %ages for all the actives. If it contains 4% HQ, 0.05% RA & MF in a small %age, it may be considered a modified Kligman's formula. If so, I'm definitely going to try it. If the HQ is only at 2%, it might be a good unevenness/melasma treatment for fair Asians & Caucasians. Either way, knowing would be good since more & more white people with this issue are joining up & looking for treatment options. I'll let you guys know as soon as ADC lets me know.
Thanks Ondine... im glad you posted... the steroid component is a little scary..
 

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I have also noticed that in many of the studies there is clear language that stipulates that the collagen- building effect of the Retin-A mitigates any insult caused by the use of a corticosteroid, so no harm was deemed in the combined used of the 2 ingredients.
 

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Discussion Starter #19
Ondine, as Clever Crescent pointed out, Dexamethasone is not just a steroid thats used to reduce the Retin-A's irritation but it is potent and proven to drastically reduce/inhibit tyrosinase acitivity so it gives the Kligman's formula a great boost up. Kligman used the retin-a and hq together first to treat melasma patients with success for a period of time but with the addition of DM the melasma patients didnt report a relapse of their hyperpigmentation.



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Ondine, as Clever Crescent pointed out, Dexamethasone is not just a steroid thats used to reduce the Retin-A's irritation but it is potent and proven to drastically reduce/inhibit tyrosinase acitivity so it gives the Kligman's formula a great boost up. Kligman used the retin-a and hq together first to treat melasma patients with success for a period of time but
with the addition of DM the melasma patients didnt report a relapse of their hyperpigmentation.[/QUOTif itsE]

Wait No relapses.. OMG, that sounds good! I'm gonna join yall in the study.. if its not harmful thats awesome.. but the ADC product was pill form.. not sure if thats the same..
 
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