This topical gel contains hydroquinone 4.5%, tretinoin 0.025%, fluocinolone 0.01%, and Niacinamide 4%. It is available by prescription in a 30 g pump.

This combination is formulated in an anhydrous gel. This smooth, creamy base has a refined cosmetic feel, leaving no greasy or tacky residue. It provides emollient, moisturizing effects that soften skin while delivering active ingredients.

Hydroquinone is a depigmenting agent. It is thought to suppress the melanocyte metabolic process [1].

Tretinoin, a derivative of vitamin A, modifies epidermal cell turnover and differentiation. It is a versatile topical agent used not only for hyperpigmentation but also for acne, aging skin, keratosis pilaris, and rosacea. In pigmentation therapy, tretinoin may enhance the penetration of other active ingredients and promote even exfoliation [2].

Fluocinolone is a mild corticosteroid that reduces irritation and inflammation [3].

Niacinamide is also known as vitamin B3 and nicotinic acid. The existing clinical data and literature on niacinamide suggests that it is an inexpensive, safe drug with beneficial effects as an adjunct in many dermatological diseases because of its anti-inflammatory, anti-oxidant, barrier repair and protective effects. It can be used as a topical drug without any major adverse effects [4].

Skin color disorders can be caused by various factors, such as excessive exposure to sunlight, aging and hormonal imbalance during pregnancy, or taking some medications. This 4-ingredient combination gel may be considered by providers treating patients with melasma, freckles, or other areas with melanin hyperpigmentation.

The skin, as the largest organ of the human body, serves as the primary barrier against environmental factors. Constantly exposed to ultraviolet (UV) radiation, pollution, and other external stressors, it relies on internal defense mechanisms to maintain its integrity and function. One such mechanism is melanogenesis, the enzymatic process by which melanin is produced to protect the skin from UV damage [5]. However, when melanin production is disturbed or unevenly distributed, it can lead to hyperpigmentation, a common cosmetic and dermatological concern. This typically presents as irregular, darker patches of skin, often occurring in areas frequently exposed to sunlight. Post-inflammatory hyperpigmentation can also develop after skin trauma or inflammation and may persist for weeks to years. Inflammation triggers the release of prostaglandins, leukotrienes, and thromboxanes, which stimulate melanocyte activity and increase melanin synthesis in the epidermis [6].

1. PRESCRIBER & PATIENT INFORMATION

Prescribing clinician’s name, licensing information, address and contact information. Patients’ full name, date of birth, shipping address and contact information.

2. COMPLETE PRESCRIPTION INFORMATION

Include: drug, dosage, and dosage form, quantity, SIG, and refills if requested.

3. PRESCRIPTION TRANSMITTAL

Fax: (940) 382-2694
Phone: 940-382-6758 | Speak to a pharmacist
Escribe ID: 0903012660 or CARIE BOYD Pharmaceuticals

•  Select Medication from the drop-down menu (bulk ingredient or powder is OK)
•  Use the words Please Compound in the SIG or Comments section followed by the compounded medication you want to prescribe.

NOTE: If you cannot find the same strength or form, that’s OK, write exactly what you want into the SIG or Comments section. In most cases we’ll be able to custom compound the prescribed medication.

Store at controlled refrigerated temperature. Protect from heat and avoid freezing.

[1] Lexicomp. (n.d.). Hydroquinone: Drug information. In Lexicomp Online. Wolters Kluwer. Retrieved August 26, 2025 from https://www.online.lexi.com/
[2] Ebanks JP, Wickett RR, Boissy RE. Mechanisms regulating skin pigmentation: the rise and fall of complexion coloration. Int J Mol Sci. 2009;10(9):4066-4087. Published 2009 Sep 15. doi:10.3390/ijms10094066
[3] Lexicomp. (n.d.). Fluocinolone: Drug information. In Lexicomp Online. Wolters Kluwer. Retrieved August 26, 2025 from https://www.online.lexi.com/
[4] Bains P, Kaur M, Kaur J, Sharma S. Nicotinamide: Mechanism of action and indications in dermatology. Indian J Dermatol Venereol Leprol 2018;84:234-237
[5] Brenner M, Hearing VJ. The protective role of melanin against UV damage in human skin. Photochem Photobiol. 2008;84(3):539-549. doi:10.1111/j.1751-1097.2007.00226.x
[6] Wawrzyk-Bochenek I, Rahnama M, Stachura M, Wilczyński S, Wawrzyk A. Evaluation of the Reduction of Skin Hyperpigmentation Changes under the Influence of a Preparation Containing Kojic Acid Using Hyperspectral Imaging-Preliminary Study. J Clin Med. 2023;12(7):2710. Published 2023 Apr 4. doi:10.3390/jcm12072710