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Active Ingredients
Important Disclaimer
These statements have not been evaluated by the Food and Drug Administration (FDA). Compounded products are not FDA-approved and are not intended to diagnose, treat, cure, or prevent any disease. Individual results may vary. The information provided is for educational purposes only and should not be considered medical advice. Always consult with your healthcare provider before starting any new treatment.
Clinical Information
Evidence-based details for healthcare providers
Use as directed by your healthcare provider. Apply a thin layer to the affected skin once daily, usually at night, unless your provider gives other directions. If you miss a dose, use it when you remember unless it is almost time for your next dose. Do not apply two doses at the same time.
Hydroquinone and kojic acid slow the skin’s pigment cells from making melanin, which causes dark spots. Tretinoin speeds up skin cell turnover so old pigmented cells shed faster and new, lighter cells rise to the surface. Hydrocortisone is a mild steroid that reduces redness and itching that can happen when the other agents work. Most people start to see fading after 4–8 weeks of daily use, with full benefit at about 12 weeks. Effects last as long as treatment continues and sun protection is used.
Do not use if you are pregnant, trying to become pregnant, or breastfeeding, as tretinoin may harm an unborn baby. Do not use if you are allergic to hydroquinone, kojic acid, tretinoin, hydrocortisone, or any ingredient in this cream. Avoid using on broken, infected, or sunburned skin. Not for use on children under 12 years unless directed by a pediatric dermatologist. Do not apply if you have active eczema, rosacea flare, or viral, fungal, or bacterial skin infections in the treatment area because the steroid can worsen these problems.
Avoid using other retinoid products (like adapalene or topical vitamin A) at the same time to reduce irritation. Do not mix with products that contain benzoyl peroxide or hydrogen peroxide; they can cause temporary dark staining of the skin. Using strong exfoliants, alcohol-based toners, or abrasive scrubs may increase redness and peeling. Tell your provider if you take photosensitizing medicines such as doxycycline or isotretinoin, as they can raise sunburn risk. Limit alcohol-based skin products and always use a broad-spectrum sunscreen during the day.
Very common (more than 1 in 10 people): mild stinging, redness, or peeling in the first few weeks. Common (1–10 in 100 people): dryness, itching, mild burning, temporary lightening of nearby normal skin. Uncommon (1–10 in 1,000 people): acne flare, swelling, or increased sensitivity to sunlight. Rare but serious: severe allergic rash, blistering, or blue-black darkening of skin (ochronosis) with long-term hydroquinone use. Most mild effects improve after the skin adjusts or with every-other-night use. Stop use and contact your provider right away if you notice severe irritation, blistering, or signs of infection.
Store tightly closed at room temperature (68-77°F, 20-25°C). Keep away from direct sunlight, heat sources, and excess moisture such as bathrooms. Do not freeze. Use within 90 days of opening for best potency, as tretinoin and hydroquinone can break down over time. Keep out of reach of children. Dispose of unused or expired cream through a pharmacy take-back program or seal it in a plastic bag mixed with coffee grounds before throwing it in household trash.
Frequently Asked Questions
How long before I see my dark spots fade?
Most people notice some lightening in 4 to 8 weeks, but full results can take up to 12 weeks. Keep using the cream every night and wear sunscreen daily for best results.
Can I use this cream during the day?
It is usually applied at night because sunlight can break down tretinoin and hydroquinone. If your provider tells you to use it during the day, apply a broad-spectrum SPF 30 or higher over it and avoid direct sun.
My skin is getting red and peeling—is that normal?
Mild redness and peeling often happen in the first few weeks and mean the medicine is working. You can apply a gentle moisturizer 10 minutes after the cream or use it every other night until your skin adjusts. Call your provider if the irritation is severe or lasts more than a few days.
Can I use makeup or other skin products with this cream?
Yes, but apply the cream first, let it dry for about 10 minutes, then use gentle, non-comedogenic makeup. Avoid harsh scrubs, alcohol-based toners, or other prescription skin treatments unless your provider says they are safe to combine.
Is it safe for people with sensitive skin?
Many people with sensitive skin can use it, but you may need to start with every-other-night use and add a bland moisturizer. Stop using it and speak with your provider if you get severe burning, swelling, or rash.
What happens if I stop using the cream?
Your dark spots may slowly return over a few months because the skin starts making pigment again. To keep results, your provider may recommend a maintenance plan, such as using the cream less often or switching to milder brightening products.
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