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Analytic quantification of the bleaching effect of a 4-hydroxyanisole-tretinoin combination on actinic lentigines.

Author(s): Pierard-Franchimont C, Henry F, Quatresooz P, Vroome V, Pierard GE

Affiliation(s): Department of Dermatopathology, University Hospital Sart Tilman, Liege, Belgium.

Publication date & source: 2008-09, J Drugs Dermatol., 7(9):873-8.

Publication type: Randomized Controlled Trial

BACKGROUND: Solar lentigines represent a common feature of photoaging, particularly on the back of the hands. Bleaching agents are usually proposed to lighten the shade of the lesions. METHODS: The study was randomized and designed to assess the effect of a bleaching solution containing 2% mequinol (4-hydroxyanisole, 4HA) and 0.01% tretinoin (Solage). The formulation was applied twice daily for 3 months on solar lentigines present on the back of one hand. The lesions on the other hand were treated with the ethyl alcohol vehicle which served as a control. Clinical diagnosis was confirmed using dermoscopy. In addition, objective measurements of the hypermelanosis were performed at 1-month intervals during and after treatment. Clinical assessments were used as well as narrow-band reflectance spectrophotometry, image analysis of video-recorded ultraviolet light-enhanced visualization (ULEV method) and photodensitometry of the corneomelametry test. RESULTS: The multipronged assessment of the lesional color demonstrated a significant lightening effect of the 4HA/tretinoin solution. This was demonstrated after 2 months of treatment and was maintained at least 2 months after stopping treatment. CONCLUSION: Both the visual ratings and the objective bioinstrumental methods indicate the rapid lightening effect of the 4HA/tretinoin formulation. After stopping treatment, the rate of repigmentation appeared to have slowed compared to the depigmentation phase.

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