Specialist Skin Creams (Tretinoin & Hydroquinone) Information

There are literally hundreds of different brands of skin care products available worldwide that claim they can improve skin tone, reduce wrinkles, or the appearance of age spots, etc. Many of these products are sold as “cosmeceuticals” which is a term that describes products that fall somewhere between cosmetics and drugs.

Products that fall into the cosmeceutical realm can contain ingredients such as Vitamins A, C, and E, panthenol, essential fatty acids, alpha hydroxy acids, ginkgo biloba, aloe vera, jojoba, allantoin, urea, and prickly pear!

You will come across a range of different manufacturers and product lines which sometimes claim to be exclusively produced for beauty salons, spas, or cosmetic clinics.

Please see the Product Brands section above for details of some of the the vast range of different professional skincare or cosmecutical ranges that you may encounter in private clinics.

In the following information below, we have outlined two prescription creams that may be prescribed by a doctor or surgeon and are often recommended to help with certain skin problems caused by ageing. These are, Tretinoin, made from Vitamin A, which is licensed for the treatment of sun damaged skin and Hydroquinone which is a skin bleaching agent.

Both are available on private prescription.

Tretinoin:

Tretinoin is made from Vitamin A (which is also known as a “retinoid”). This product is best known as an anti-acne treatment. It was first used in the 1970s for this purpose, when some young and middle – aged women reported improvement in fine wrinkles around their eyes when they were using this product for facial acne.

As a consequence, strict medical trials were performed in the late 1980s that proved that tretinoin could indeed reduce the appearance of fine facial wrinkling and also reduce the appearance of some facial hyperpigmentation (or age spots). It appears that tretinoin works by stimulating the production of collagen, which improves the skin’s appearance, and by also reducing the production of the pigment, melanin, in the skin.

As a result of this, tretinoin became the first and is still the only prescription drug able to claim that it could improve the roughness and fine wrinkling of sun damaged skin.

Hydroquinone:

Hydroquinone is a powerful skin bleaching agent. It works by stopping the pigment-producing cells in the skin from working. This pigment is called melanin and it is this which gives our skin its colour.

This is a reversible process and the skin can produce melanin again when hydroquinone is no longer used. It is often seen as the most effective topical product that dosctors use to treat melasma and other causes of hyperpigmentation (areas of darker coloured skin).

Tretinoin:

In adults and elderly patients, tretinoin should be applied daily at night. Just enough cream should be used to cover the affected areas thinly. Once the maximum effect has been achieved (after about 3 - 6 months) it can be maintained by continuing to apply tretinoin cream one to three times a week.

This product can make your skin more sensitive to the sun so you should avoid sunbathing or sunbeds. You should also always use a sunblock recommended by your practitioner to help prevent further sun damage to your skin.

In medical trials, the only adverse reaction to the cream was skin irritation. Mild to moderate skin reactions (e.g. dryness, peeling, redness, burning, stinging, and itching) are seen in many patients when they start this treatment. If this occurs, patients are usually recommended to stop treatment for a few days, and then start treatment again with a tiny pea sized amount spread over the area to be treated.

Tretinoin is a pharmaceutical product that is only available on prescription from a doctor or surgeon in the U.K.. It is possible to purchase some prescription drugs, including tretinoin, directly from the internet without a doctor’s prescription. We would, however, strongly advise you not to begin using this product without first seeing a specialist.

Hydroquinone:

This product is available in low strengths of 2% or less, by itself, or in combination with other products such as alpha hydroxy acids, without a prescription. Higher strengths require a prescription from a suitably qualified practitioner.

Hydroquinone can cause skin irritation with itching and redness, which can make it unsuitable for some patients.

It must be used alongside a high factor sunblock, and should not be used for more than a few months without a break of at least a month owing to the potential risk of developing a condition called ochronosis (This is a abnormality in our metabolism which can result in the surface of the skin of the face, as well as in the whites of the eyes, becoming a brownish colour.) This is especially important in people with black skin.

As with tretinoin, it is possible to purchase some of these creams over the internet without a prescription, but you are strongly advised not to start using hydroquinone without first seeking the advice of a specialist.

People with black skin are not advised to use lightening creams since they can cause a very dramatic and ugly change of skin colour where they have been applied. The cream leaves irregular white or dark patches, which are hard to cover up. There is no safe way to lighten dark skin permanently.

Tretinoin and Hydroquinone 4% are available on private prescription.

Tretinoin:

Tretinoin is available on private prescription and, depending on the brand, concentration and tube size prices are around £45 - £65 per tube. 

Hydroquinone:

Hydroquinone 4% is available on private prescription and, depending on the brand, prices are around £30.00 per tube.

Tretinoin:

There is evidence from carefully controlled medical trials in large numbers of patients that tretinoin 0.05% cream can improve some of the signs of sun damaged skin. The only adverse effects associated with this treatment are skin irritations and mild peeling.

As a result, many practitioners will recommend the use of tretinoin as part of a skin improvement treatment package.

Hydroquinone:

This can be an effective product for reducing the appearance of areas of discoloured skin if used under the proper guidance of a specialist.