title: Clinical trial of bleaching treatment with 10% all-trans retinol gel.
abstract: BACKGROUND
  Although an aggressive use of tretinoin along with hydroquinone enables an efficient treatment of hyperpigmented skin lesions, irritant dermatitis remains to be solved.
  
  
  OBJECTIVE
  To evaluate the efficiency and adverse effects of 10% all-trans retinol (ROL) gel for improvement of skin hyperpigmentation.
  
  
  METHODS
  Ten-percent ROL gel was used instead of 0.1% tretinoin gel in our two-phased bleaching protocol (bleaching and healing phases); 5% hydroquinone and 7% lactic acid ointment were used along with ROL gel in the bleaching phase (2 to 6 weeks). Five-percent hydroquinone and 7% ascorbic acid ointment were used alone during the healing phase (4 to 6 weeks). Twenty-one Japanese patients with hyperpigmented lesions on the face were enrolled in this study, and 18 patients who were followed for more than 10 weeks were analyzed.
  
  
  RESULTS
  Improvement of pigmentation was seen in 16 of 18 patients after an average treatment period of 11.3 weeks, and in 6 patients, pigmentation was almost eliminated after treatment. Erythema and scaling were seen, however, during the bleaching phase as well as the bleaching treatment with tretinoin gel.
  
  
  CONCLUSIONS
  ROL can improve skin hyperpigmentation to a similar extent to tretinoin when used at high concentration, whereas it induces irritant dermatitis as well.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Tokyo, Graduate School of Medicine, Tokyo, Japan. yoshimura-pla@h.u-tokyo.ac.jp
authors.forename: Kotaro
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Akira
authors.initials: A
authors.lastname: Momosawa
authors.forename: Emiko
authors.initials: E
authors.lastname: Aiba
authors.forename: Katsujiro
authors.initials: K
authors.lastname: Sato
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsumoto
authors.forename: Yoko
authors.initials: Y
authors.lastname: Mitoma
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Harii
authors.forename: Takao
authors.initials: T
authors.lastname: Aoyama
authors.forename: Tatsuji
authors.initials: T
authors.lastname: Iga
mesh_terms: D000328:Adult; D000368:Aged; D001205:Ascorbic Acid / Q000008:administration & dosage; D017453:Dermatitis, Irritant / Q000209:etiology; D004359:Drug Therapy, Combination; D004890:Erythema / Q000209:etiology; D005260:Female; D005782:Gels; D006801:Humans; D006873:Hydroquinones / Q000008:administration & dosage; D017495:Hyperpigmentation / Q000188:drug therapy*; D019344:Lactic Acid / Q000008:administration & dosage; D008875:Middle Aged; D016896:Treatment Outcome; D014801:Vitamin A / Q000008:administration & dosage*
chemical_list: D005782:Gels; D006873:Hydroquinones; D014801:Vitamin A; D019344:Lactic Acid; D001205:Ascorbic Acid; C031927:hydroquinone