1 Kligman's 5% Hq Formula on Wed Jan 13, 2010 9:59 pm
Here is the Kligman's Hq formula that I had copied and pasted from a dermatology site, in which I pasted the link below. Enjoy.
- Hydroquinone powder 5%
- Dexamethasone powder 0.1%
- Tretinoin powder 0.1%
- Hydrophilic ung qs ad 60gm
The reference is O.H. Mills and A.M. Kligman, J. Soc. cosmet. Chem., 1978, 29, 147.
There are of course other variations. One pharmacist I know dissolves the HQ powder in propylene glycol prior to mixing in hydrocortisone powder, tretinoin powder, and then blending with Unibase cream.
I credit Kligman with all variations of the concept of hydroquinone, tretinioin, steroid creams. The exact method of preparation of what I was using with great success was combining in order:
- Water 3ml
- Hydroquinone powder (Kodak) 5gm
- Retin A 0.05% cream (DNS) 15gm
- Lidex cream (DNS) 15gm
- Eucerin cream (DNS) qs ad 50 gm
The HQ is dissolved in the water first, then the creams are combined, and finally all are mixed thourougly by hand. This makes 50gm of a very nice stable bleaching cream which emulsifies nicely. The fluocinonide content is 0.015% and use is carefully monitored by giving the patient 10gm jars at a time. I have never seen atrophy or steroid induced rosacea from use of this, but it is a concern of course. The patient is instructed to apply at hs and use high SPF sunscreen every AM. The advantages are:
1) Patients love it, a prescription made just for them by the dermatologist, and they don't have to pay for it. NO prescription cost to the patient
2) Minimal cost to the dermatologist since ingredients are free samples exept for the HQ powder which is inexpensive
3) Very individualized treatment with control of supply by the dermatologist. The problem is that samples of Lidex cream (DNS) are no longer available, and I have had problems with the emulsification of other steroid creams (they tend to separate in a few days). Horror of horrors, I may actually have to buy ingredients?
In our setting, we have tried from low potency: hydrocortisone to mid potency fluocinonide or betamethasone combination in our bleaching preparation. We find the combination hydroquinone + Tretinoin .05 + hydrocortisone to be the most effective in terms of effect and cost. Hydrocortisone is cheaper in Manila. Lately we are trying to use desonide cream (DesOwen) to see if it is better than hydrocortisone.
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