Many dermatologists have found that combining the use of tretinoin and glycolic acid with a bleaching agent provides an additive benefit. The regime we recommend to patients is as follows:

Cleanse the face in the morning with a mild soap, let dry for 20 minutes and apply Retisol-A in a concentration that suits you. You will recall from our discussion on tretinoin that Retisol-A contains tretinoin, moisturizing agents and a broad spectrum sunscreen with an SPF of 15.

In the evening cleanse the face again and wait 20 minutes. Apply a cream, gel or lotion that contains glycolic acid and hydroquinone or kojic acid. The hydroquinone once exposed to the air will turn the product a rusty red. Other than looking a bit unusual this is of no consequence. Kojic acid is just as effective for bleaching discolorations of the skin but does not oxidize when exposed to the air. NeoStrata HQ contains glycolic acid and hydroquinone and Reversa HQ is in a hydro alcoholic gel base with glycolic acid 10% and hydroquinone 2%.