An effective treatment to improve blotchy hyperpigmentation is the use of 4% hydroquinone. This concentration of hydroquinone is "physician strength" and not available over-the-counter. 2% hydroquinone is available over-the-counter but is not as effective in achieving results.

Glyquin XM with Sunscreen and Obagi Nu-Derm Clear are two products that contain 4% hydroquinone. Glyquin XM Skin Lightening Cream is designed to slowly "lighten" hyperpigmented skin conditions such as discoloration, brown spots or an uneven skin tone. Glyquin XM Skin Lightening Cream contains 4% hydroquinone, 10% glycolic acid, vitamin C and E, a broad-spectrum sunscreen with SPF 15 and hyaluronic acid. Hyaluronic acid is a super-moisturizing ingredient which was added to Glyquin to relieve the irritation that is sometimes associated with hydroquinone use.

Obagi Nu-Derm Clear is part of an advanced skincare system and contains physician-strength 4% hydroquinoine, glycolics and tretinoin (Retin-A) to enhance effectiveness in improving hyperpigmentation in an easy to use series of numbered containers. It is not available over-the-counter or through spas. 

The Obagi NuDerm System begins to clear the skin in 2 weeks, with dramatic results by 8 to 12 weeks. Sometimes an Obagi Blue Peel at a later date will provide additional clearing.

From Left to Right: 
Photo 1: Before Obagi Nu-Derm Products: This patient came to our office with severe sun damage and mottled hyperpigmentation. Photo 2: 6 week follow-up Obagi Nu-Derm Products: Note improved complexion and reduction of cheek wrinkles. Photo 3:  22 day follow-up Obagi 15 percent Blue Peel: Customized Obagi 15 percent TCA Blue Peel (2 coats). Note tightening of skin and improvement of wrinkles. Continued clearing of complexion. Now on a maintenance program for the Obagi Nu-Derm products. Photo 4:  10 month follow-up Obagi 20 percent Blue Peel:  Customized Obagi 20 percent TCA Blue Peel was performed 2 months after her first 15 percent Blue Peel. Note the rose color is the result of increased blood supply to the collagen layer.
 
If hyperpigmentation is due to Melasma (usually hormonal), treatment with the Obagi NuDerm System is equally effective as shown in the photographs below.

From Left to Right: 
Photo 1: Before Obagi Nu-Derm Products: Severe hyperpigmentation, melasma and acne. Hyperpigmentation may be hormonal. Obagi Nu-Derm Advanced Skincare System recommended with 0.025% Tretinoin. Photo 2: 3 week follow-up Obagi Nu-Derm Products: Reduction in uneven skin tone. Improved skin clarity. Some blemishes due to mild irritation. Photo 3:  6 week follow-up Obagi Nu-Derm Products: Amazing results. Skin tone is more even. Reduction in hyperpigmentation. Fewer blemishes. Patient will continue with the Obagi Nu-Derm System for 2-3 skin care cycles (12 to 18 weeks). Photo 4:  26 week follow-up Obagi Nu-Derm Products: Excellent results after 4 skin cycles. Patient now on maintenance program. Malasma has completely disappeared. Patient very pleased with the results of the Obagi Nu-Derm Advanced Skincare System.

For more information or ordering information on Glyquin XM or the Obagi NuDerm System, visit our Skincare-MD.com website. Additional before and after photographs can also be found on our skincare website.

Contact Us With Your Questions
As always, we encourage you to call our office and speak to our licensed Esthetician, if you have any questions. We are always happy to talk to you about your skin type and condition and make product recommendations based on your conversation. Our MD Forte, Obagi Nu-Derm, Obagi-C Rx and Kinerase Advanced Skin Care Programs are all excellent for skin rejuvenation. We can help you decide which skin care program would be best for you. Our esthetician is available during office hours Monday through Friday 8:30 a.m. to 7:30 p.m. EST at 1-877-415-0600 or (603) 296-4920. You may also email us at info@skincare-md.com if you have any questions.

A reporter noted a bandaid on Laura Bush's skin. Biopsy revealed a squamous cell carcinoma and the area was treated.

There are 3 types of skin cancer: The most common and the most benign is basal cell carcinoma. A more malignant form of skin cancer is squamous cell carcinoma. This form can spread to other areas (metastasis). The most aggressive form of skin cancer is due to melanoma.

All skin cancers are caused by excessive sun exposure without adequate sun protection. As we continue to have deterioration of the ozone layer, skin cancers are making their appearance in a variety of locations other than the face. The skin cancer involving our first ladies leg is one such example of skin cancers appearing in unusual locations.

From Left to Right: Illustration 1: Basal cell carcinoma may come in many forms. It often begins as a small, pearly nodule. Illustration 2: Squamous cell carsinoma may begin as a red, scaly patch, a group of crusted nodules, or a sore that doesn't heal. Illustration 3: Malignant melanoma is often asymmetrical, with blurred or ragged edges and mottled colors. Basal and squamous cell carcinomas can vary widely in appearance.