Obagi Nu-Derm

The Obagi Nu-Derm regimen is not only effective in treating epidermal melasma, but can also improve wrinkles, smooth and firm the skin when used in combination with tretinoin cream.

Images


Effects


Grade Level of Evidence
A Double-blind, controlled study with more than 50 participants.
B Controlled study that is single-blind or has less than 50 participants.
C Controlled or comparative study.
D Uncontrolled or observational study.
Grade Effect Size of Effect Comments

D

Skin lightening

Strong

Improved brown spots and discolouration in 68% of subjects after 12 weeks and in 96% of subjects after 24 weeks of treatment.

D

Melasma treatment

Strong

Markedly reduced melasma severity and pigmentation intensity, with visible improvements observed as early as on the 4th week.

D

Smoother skin

Strong

Improved skin texture/roughness in 85% of subjects after 12 weeks, and in all patients after 24 weeks.

D

Wrinkle treatment

Moderate

Improved fine lines and wrinkles in 70% of subjects after 12 weeks, with the proportion rising to 92% after 24 weeks.

D

Increased skin elasticity

Moderate

Improved skin firmness in 70% of subjects after 12 weeks, and in all patients after 24 weeks.

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Ingredients


Hydroquinone (4%), Alpha Hydroxy Acids, Zinc Oxide (Micronized), Octinoxate, Hydrocortisone (0.5%)
NAME ANTIOXIDANT UV PROTECTION COMEDOGENIC IRRITANT SAFETY
HYDROQUINONE (STABILISING) NO DATA NO DATA BANNED (SOURCE)
ALPHA HYDROXY ACIDS NO RECORDS FOUND
ZINC OXIDE (BULKING, SKIN PROTECTING, UV ABSORBER) 1 (SEE SOURCES) 0 (SEE SOURCES) ALLOWED (SOURCE)
ETHYLHEXYL METHOXYCINNAMATE (UV ABSORBER, UV FILTER) 0 (SEE SOURCES) 0 (SEE SOURCES) ALLOWED (SOURCE)
HYDROCORTISONE (0.5%) NO RECORDS FOUND

Clinical Studies


Treating epidermal melasma with a 4% hydroquinone skin care system plus tretinoin cream 0.025%.

Products

Obagi Nu-Derm Foaming Gel

Obagi Nu-Derm Toner

Obagi Nu-Derm Clear

Obagi Nu-Derm Exfoderm Forte

Obagi Nu-Derm Healthy Skin Sun Protection SPF 35

Obagi Nu-Derm Blender

0.025% tretinoin cream

Obagi Nu-Derm Action

Obagi Nu-Derm Tolereen

Trial Design

Unblinded, uncontrolled

Duration

12 weeks of treatment

Subjects

20 women of Fitzpatrick phototypes IV, V or VI who were aged 50 years on average and had mild or moderate epidermal melasma, minimal to marked intensity of melasma pigmentation and cutaneous melanosis that had been stable over the past 3 months.

Regimen

Applied the cleanser (Obagi Nu-Derm Foaming Gel), toner (Obagi Nu-Derm Toner) and hydroquinone (Obagi Nu-Derm Clear) twice daily. Applied the exfoliation enhancer (Obagi Nu-Derm Exfoderm Forte) and sunscreen (Obagi Nu-Derm Healthy Skin Sun Protection SPF 35) every morning. Applied 0.5g of the tretinoin cream mixed with 0.5g of 4% hydroquinone (Obagi Nu-Derm Blender) every evening.

Participants could also use a moisturizer (Obagi Nu-Derm Action) to combat dryness or 0.5% hydrocortisone (Obagi Nu-Derm Tolereen) for other tolerability issues.

Methods of Assessment

Investigator evaluations of melasma severity, melasma pigmentation intensity, melasma area and severity (MASI) score and melasma improvement.

Patient assessments of how embarrassed or self-conscious they had been because of their skin, how much their skin discolouration had made them feel unattractive to others, how much effort they had put into hiding their skin discolouration from others, how much others had focused on their skin discolouration rather than on what they were saying or doing, and how much their skin had affected any of their social and leisure activities.

Patient ratings of their satisfaction with the overall effectiveness of the treatment, the effectiveness of the treatment compared with other medications, their overall facial improvement, and improvements in fine lines and wrinkles, skin texture/roughness, skin firmness, and brown spots/discolouration.

Side Effects

3 patients had adverse events that were considered probably related to treatment, including dryness, erythema, peeling and stinging sensation. All were mild, except for 1 case of erythema that was moderate.

Conflicts of Interest

Study was funded by Obagi Medical Products. The first author was an investigator and consultant for the company, and the second author was an employee who held stock options.

Effects observed in this study:

Treatment with the Obagi Nu-Derm regimen was associated with significant reductions in melasma severity, pigmentation intensity and MASI score from the 4th week onwards. At the end of 12 weeks, 80% of patients had achieved at least a 1-grade improvement in melasma severity, while 85% had achieved at least a 1-grade improvement in pigmentation intensity. The proportion of patients with at least a marked (>50%) improvement in melasma was 60% at the same time point.

Importantly, patients felt that their quality of life was improved following treatment. Only 20% of patients felt embarrassed or self-conscious about their skin at week 12, compared to 80% in the beginning. Similarly, the proportion of patients who believed that their skin discolouration made them unattractive to others declined from 80% to 35%. Overall, 90% considered the treatment to be more or much more effective than other medications.

The majority of participants also reported improvements in skin photodamage. 85% reported good, very good or excellent improvement in skin texture/roughness, 70% for fine lines and wrinkles, 70% for skin firmness, and 68% for brown spots/discolouration.

Open-label treatment of moderate or marked melasma with a 4% hydroquinone skin care system plus 0.05% tretinoin cream.

Products

Obagi Nu-Derm

0.05% tretinoin cream

Obagi Nu-Derm Action

Obagi Nu-Derm Tolereen

Trial Design

Open-label, uncontrolled, multicenter

Duration

12 or 24 weeks of treatment

Subjects

37 women of Fitzpatrick phototypes III, IV, V or VI and with a mean age of 46 years. They presented with moderate or marked epidermal melasma and melasma pigmentation of mild-to-marked intensity. The cutaneous melanosis was required to have remained stable for the last three months.

Regimen

Applied the foaming gel cleanser, toner and 4% hydroquinone twice daily, the exfoliant and sunscreen each morning, and the tretinoin 0.05% cream mixed 1:1 with 4% hydroquinone each evening.

Also allowed to use a provided moisturizer (Obagi Nu-Derm Action) and/or 0.5% hydrocortisone (Obagi Nu-Derm Tolereen) for dryness and other tolerability issues.

Methods of Assessment

Investigator evaluations of melasma severity, pigmentation intensity and melasma improvement.

Patient assessments of the overall effectiveness of the treatment, its effectiveness compared to other treatments and the levels of improvement observed in skin texture/roughness, skin firmness, brown spots/discolouration and fine lines and wrinkles.

Patient evaluations of parameters related to their quality of life - how embarrassed or self-conscious they had been because of their skin, how much their skin discolouration had made them feel unattractive to others, how much effort they had put into hiding their skin discolouration from others, how much others had focused on their skin discolouration rather than on what they were saying or doing, and how much their skin had affected any of their social and leisure activities.

Side Effects

4 patients had adverse events that were probably or definitely related to treatment, including moderate erythema, moderate vesicles/erythema, mild dryness/tightness/soreness, and mild acne.

Conflicts of Interest

Study was funded by Obagi Medical Products. All of the authors were consultants, investigators or employees of the company.

Effects observed in this study:

The treatment regimen led to significant reductions in melasma severity and pigmentation intensity starting from the 4th week. Melasma severity was moderate in 76% of patients and marked in 24% at baseline, but only 12% had melasma that was still of at least moderate severity at week 24. Likewise, the proportion of patients whose melasma pigmentation was of at least moderate intensity decreased from 73% to 8% after 24 weeks.

All the patients who underwent treatment for 24 weeks were satisfied with the effectiveness of the treatment, considering it to be more or much more effective than other treatments. Most also noticed improvements in their skin texture/roughness (100%), skin firmness (100%), brown spots/discolouration (96%) and fine lines and wrinkles (92%) after 24 weeks of treatment. The quality of life of the patients also improved.