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What is the Kligman formula?

The original Kligman formula has been—and still is—the most popular physician prescribed treatment option for hyperpigmentation. Dr. Kligman’s idea was to combine several key ingredients to help fade dark spots quickly and effectively. The formula has been tweaked slightly over time and is typically found with the below triple combination of compounds;

1. Hydroquinone: a medical-grade skin lightening agent (~4-8%) reduces the activity of tyrosinase, an enzyme involved in the production of new melanin (i.e pigment). It is more effective than other brightening ingredients such as kojic acid, glycolic acid, and azelaic acid.

2. Retinoids: prescription-strength vitamin-A derivative (.025% tretinoin) to increase penetration of hydroquinone

3. Hydrocortisone: a mild steroid (mometasone 1.0%) to reduce the side effects of skin irritation induced by the two other active ingredients.

How effective is the Kligman formula?

Kligman’s formula is the most effective hyperpigmentation formula available. Combined with sunscreen it can help treatment of melasma, fade sun-induced dark spots (age spots), and is especially helpful with the treatment of post-acne dark spots.

What are the disadvantages for the Kligman formula?

1. Hydroquinone percentage: The high percentage of hydroquinone (4-8%)used in the formulas prescribed by dermatologists, causes, in some rare cases of local paradoxical skin darkening (AKA ochronosis). This adverse effect is more frequent in people with dark skin types.

2. Prescription: Since the Kligman formula is that it is only available with a prescription, it requires a dermatologist office visits to obtain. That on top of the cost of the prescription from a pharmacy can put the prescription formula out of the price range for many.

3. Hydrocortisone: The weak link in the Kligman formula is hydrocortisone. Using topical steroids on the face for a long period of time can make the skin thinner, dilate skin capillaries, and lead to other skin conditions such as fungal acne and perioral dermatitis. Because of this, the Kligman formula should not be used for extended periods of time.