title: Comparative study of hydroquinone-free and hydroquinone-based hyperpigmentation regimens in treating facial hyperpigmentation and photoaging.
abstract: BACKGROUND
  Photoaged skin, characterized by mottled, irregular areas of pigmentation, is a common skin condition that is often difficult to treat. The areas of hypermelanosis are an aesthetic concern to subjects and may lead to social distress and quality of life issues. There are many commercial hyperpigmentation regimens marketed to lighten dark spots and improve overall skin dyschromia. However, data to support efficacy of such kits are often lacking.
  
  
  OBJECTIVE
  This investigator-blinded, randomized trial was conducted to compare a new hydroquinone (HQ)-free hyperpigmentation regimen against a leading HQ-based hyperpigmentation regimen for the treatment of facial hyperpigmentation and photoaging.
  
  
  METHODS
  Subjects with mottled pigmentation and photodamaged facial skin were randomized to treatment with either the new 4-product (HQ-free) SkinMedica® Hyperpigmentation System (SKM; SkinMedica, an Allergan Company, Carlsbad, CA) kit or the 7-product (HQ-containing) Obagi Nu-Derm System (OMP; Obagi Medical Products, Long Beach, CA) kit. Subjects were evaluated by a blinded investigator for clinical efficacy and tolerability using grading scales at baseline and at weeks 4, 8, and 12. Standardized digital photographs were taken at baseline and week 12. Self-assessment questionnaires were completed at week 12.
  
  
  RESULTS
  Thirty-six female subjects (16: SKM; 20: OMP) completed the 12-week comparative study. Both hyperpigmentation regimens significantly reduced Overall Hyperpigmentation, Mottled Pigmentation Area and Severity Index (MoPASI), global photoaging, and sallowness at week 12 compared to baseline. Significant reductions in tactile roughness were seen with the OMP regimen at week 12. In these investigator-blinded assessments, there were no significant differences between treatment groups, nor was there a difference in global response to treatment. Investigator assessments of tolerability showed mean scores were mild or below for all parameters with both treatment regimens.
  
  
  CONCLUSIONS
  A new 4-product (HQ-free) regimen was shown to be as effective and tolerable as a 7-product (HQ-based) regimen in reducing facial hyperpigmentation and photoaging in females with mottled pigmentation and photodamaged facial skin.
authors.affiliation: Cosmetic Laser Dermatology, San Diego, CA, USA. SFabi@gbkderm.com
authors.forename: Sabrina G
authors.initials: SG
authors.lastname: Fabi
authors.forename: Mitchel P
authors.initials: MP
authors.lastname: Goldman
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006873:Hydroquinones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017495:Hyperpigmentation / Q000188:drug therapy*; D008875:Middle Aged; D017060:Patient Satisfaction; D016037:Single-Blind Method; D015595:Skin Aging / Q000187:drug effects*; D012880:Skin Pigmentation / Q000187:drug effects; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D003879:Dermatologic Agents; D006873:Hydroquinones; C031927:hydroquinone