Hydroquinone & EDC: Combo assists in wound healing, achieves better cosmetic results

Key Points

"When performing an EDC, the pre-and post-treatments of the target area with a special skincare system can cosmetically enhance the appearance of the wound after the EDC procedure is done," says James M. Spencer, M.D., Spencer Dermatology & Skin Surgery Center, St. Petersburg, Fla.

Study details

In the multicenter, investigator-blind study, 51 patients (with 59 lesions) were randomized to receive twice daily either the hydroquinone/tretinoin-based system or standard treatment with a cleanser and healing ointment.

All patients included in the study were Caucasian, with 31 percent, 35 percent, 27 percent and 6 percent having Fitzpatrick skin types I, II, III or IV, respectively.

Study results demonstrated that those patients who used the hydroquinone/tretinoin skincare system adjunctively with EDC achieved better aesthetic results post-procedure when compared to the patients who used only standard wound treatment with a cleanser and healing ointment.

"We believe that the hydroquinone and tretinoin were responsible for the improvement in the cosmetic result in those patients, because it is known that tretinoin enhances wound healing and reduces dyspigmentation, while hydroquinone evens skin coloration and minimizes dyspigmentation," Dr. Spencer tells Dermatology Times.

Tretinoin applied before wounding is known to accelerate the healing process, for instance, in chemical peels and dermabrasion. Hydroquinone is a mainstay in the treatment of hyperpigmentation, a symptom that can often occur following an EDC or any cutaneous surgical procedure, and the Kligman formula, consisting of a combination of hydroquinone, tretinoin and a steroid, is known to be very effective and state-of-the-art in treating hyperpigmentation.

Synergistic effect

According to Dr. Spencer, the Obagi skincare system has a similar synergistic effect on wounds and classically consists of a combination of hydroquinone, tretinoin and glycolic acid (and no steroid, as in the Kligman formula).

The ingredients are not mixed but applied individually and sequentially, and they appear to make a real difference in the aesthetic outcome of wounds in terms of wound healing and scar formation/prevention.

The most common wound treatment used by clinicians is simple Vaseline or petrolatum with antibiotics mixed in. Dr. Spencer says the antibiotics are not responsible for speeding the healing; instead, the acceleration is due to the chemical occlusion of the Vaseline.

Specially tailored skincare systems, such as the Obagi system, enhance wound healing more so than standard wound dressings.

"Electrodesiccation and curettage is a quick and effective procedure often used in the treatment of superficial basal cell carcinomas; however, the cosmetic results are sometimes less than optimal.

"Applying the hydroquinone/tretinoin skincare set before and after the EDC procedure gave us much better aesthetic results, underscoring the value of using such a skincare system following cutaneous surgical procedures," Dr. Spencer says.

Disclosure: The manufacturer of the system, Obagi, provided a research grant for this study.