Hydroquinone + Tretinoin + Corticosteroid

Introduction

What is hydroquinone + tretinoin + corticosteroid?

The combination of the depigmenting agent hydroquinone, the retinoid tretinoin and a corticosteroid, also known as triple combination therapy, is widely used to treat hyperpigmentation disorders. It was first proposed by the American dermatologist Albert Kligman in 1975 (R), and has since been approved by the US FDA for bleaching of hyperpigmented skin and melasma in particular (R).

Efficacy

Show 3 more outcomes
Outcome	Grade	Effect	Evidence	Studies
Hyperpigmentation	A	🠫 Slight	★★★★ Good	4 studies 133 participants
Skin Redness	C	⇧ Potential	★★★ Fair	4 studies 115 participants
Skin Hydration	C	⇧ Potential	★★ Some	2 studies 51 participants
Skin Brightness	C	⇧ Potential	★★ Some	1 study 17 participants
Skin Density	C	⇧ Potential	★★ Some	1 study 17 participants
Skin Oiliness	C	⇩ Potential	★★ Some	1 study 17 participants
Melasma	E	🠫 Slight	★★★★ Good	14 studies 2446 participants
Skin pH	E	– No Effect	★★ Some	1 study 17 participants

Mechanisms

Outcome	Grade	Effect	Evidence	Studies
Melanin	C	⇩ Potential	★★★ Fair	4 studies 133 participants
Blood Vessels	C	⇧ Potential	★★ Some	1 study 62 participants
Stratum Corneum Compaction	C	⇧ Potential	★★ Some	1 study 62 participants
Elastic Fibres	E	– No Effect	★★ Some	1 study 62 participants
Glycosaminoglycans	E	– No Effect	★★ Some	1 study 62 participants

Side Effects

Show 13 more side effects
Outcome	Effect	Frequency	Studies
Skin Hydration	⇩ Decrease	23% (43 out of 183 participants)	5 studies
Acne	⇧ Increase	5% (25 out of 470 participants)	3 studies
Hyperpigmentation	⇧ Increase	3% (12 out of 476 participants)	2 studies
Itching	⇧ Increase	5% (19 out of 403 participants)	2 studies
Inflammation	⇧ Increase	1% (2 out of 242 participants)	2 studies
Skin Barrier Function	⇩ Decrease	—	2 studies
Blepharitis	⇧ Increase	0% (1 out of 242 participants)	1 study
Contact Dermatitis	⇧ Increase	1% (3 out of 242 participants)	1 study
Rash	⇧ Increase	1% (2 out of 242 participants)	1 study
Swelling	⇧ Increase	0% (1 out of 242 participants)	1 study
Hives	⇧ Increase	0% (1 out of 242 participants)	1 study
Hair Growth	⇧ Increase	—	1 study
Skin Redness	⇧ Increase	26% (167 out of 646 participants)	11 studies
Peeling	⇧ Increase	19% (133 out of 688 participants)	10 studies
Skin Discomfort	⇧ Increase	12% (82 out of 686 participants)	9 studies
Spider Veins	⇧ Increase	5% (74 out of 1486 participants)	8 studies
Irritation	⇧ Increase	6% (36 out of 639 participants)	7 studies
Headache	⇧ Increase	18% (11 out of 60 participants)	1 study

Latest Research

Hydroquinone + Tretinoin + Corticosteroid

What is hydroquinone + tretinoin + corticosteroid?

Efficacy and safety of a novel triple combination cream compared to Kligman's trio for melasma: A 24-week double-blind prospective randomized controlled trial (2023)

Safety and efficacy of topical metformin 30% cream versus triple combination cream (Kligman's formula) in treating melasma: A randomized controlled study (2022)

French maritime pine bark extract (pycnogenol) in association with triple combination cream for the treatment of facial melasma in women: a double-blind, randomized, placebo-controlled trial (2021)

Topical metformin in the treatment of melasma: A preliminary clinical trial (2020)

Evaluation of the safety and efficacy of a triple combination cream (hydroquinone, tretinoin, and fluocinolone) for treatment of melasma in Middle Eastern skin (2019)