The Kligman formula is a pomade with a hydroquinone base, retinoic acid and corticosteroid. It is used for treating a number of very tenacious hyperpigmentation illnesses: chloasma (pregnancy mask), ephelids (freckles), post-inflammatory residual hyperpigmentation (acne, eczema, contact allergy, etc… Nevertheless, it has given no good results in patients suffering of senile lentigo (old age spots). Hydroquinone is already used in certain types of commercial preparations as a depigmentation agent (Neostrata HQ md, Eldoquin md, Ultraquin md). Retinoic acid and corticosteroid, through different action mecanisms also contribute to this result. In fact, their association is more efficient than that of each of the agents applied separately.
The prescribed concentrations of hydroquinone, retinoic acid and corticosteroid may vary according to the patient’s condition. Generally speaking, the speed of the treatment response is proportional to the concentrations used, but skin irritation is alike. Different corticosteroids may be used (hydrocortisone, dexamethasone, fluocinolone, etc…), the most powerful and efficient of which being the fluorated steroids.
The depigmentation can be observed only three to five weeks after beginning treatment. The maximum effect comes out after five to seven weeks of treatment. If no clearing of the skin has occurred after two months, there is little possibility that the pursuit of the treatment may be useful. After you have obtained the desired skin pigmentation , a single daily application of the Kligman cream per day will be sufficient to maintain the effect. A reduction of the concentration of the active ingredients may be recommended.
Prescription of active ingredients
- Retinoic acid: 0.025%
- Hydroquinone: 5%
- Hydrocortisone: 1%
- Hydranorme qs ad: 30%
This example confirms the pharmacist’s role in realizing a magistral preparation. In fact, if the pharmacist executes this prescription integrally, the preparation will get black in a few days only.
Kligman’s action will start to work instantly. You should see improvements occur after three or four months. The small wrinkles and brown spots will start diminishing. Your skin will gradually become softer, which will improve its appearance and texture. At the beginning, your skin will possibly become dryer, or lightly or moderately irritated. These results should be reduced when your skin will have adapted to Kligman. To help reduce irritation, apply an hydratant cream every morning. If you have stronger reactions, discontinue use of Kligman and consult your doctor.
Other useful advice:
- Do not apply too much Kligman, to avoid increasing the irritation risk. Follow your doctor’s instructions.
- Avoid all contact with eyes and mouth. In case of eye contact, rinse with warm water.
- Continue usage of your usual cosmetics, but avoid those who can dry or irritate your skin, such as:
- products containing alcool, spices or lime;
- certain cleaning agents and depilatory products.
Directives to start using Kligman tonight:
- Clean your face every night with a soft non medicated cleaning agent, then wipe off with a soft towel;
- Wait 20 to 30 minutes to reduce the risk of irritation;
- Apply Kligman the size of a pea (no more) on the face, when going to bed. Spread Kligman until it is fully absorbed;
- Let the cream be active all night long.
Adopt a full skin care program:
- avoid exposing excessively your skin to the sun, especially around noon;
- choose sunscreen lotions marked at least 15 FPS;
- wear protective clothes;
- use an hydratant cream.