OBAGI - Nu-Derm® 3 Clear (Hydroquinone)

Obagi Nu-Derm® Clear #3 is a 57g topical prescription cream containing hydroquinone USP 4% (40mg/g). It is prescribed for the gradual lightening of melanin-related hyperpigmentation, including melasma, chloasma, freckles and solar or senile lentigines, commonly described as sun spots or age spots.

This product is also referred to as Obagi Clear Rx, Obagi Clear with hydroquinone or Obagi hydroquinone cream. It is the prescription hydroquinone formulation and should not be confused with Obagi Nu-Derm Clear Fx, which is a different, hydroquinone-free cosmetic formulation.

Product information

• Product: Obagi Nu-Derm Clear #3
• Active ingredient: Hydroquinone USP
• Strength: 4% w/w, equivalent to 40mg of hydroquinone per gram
• Formulation: Topical cream
• Quantity: 57g / 2oz bottle
• Route of administration: External topical use
• Prescription status: Prescription Only Medicine

Indication

The prescribing information describes Obagi Nu-Derm Clear as a topical treatment for the gradual lightening of hyperpigmented skin conditions. These include:

• Melasma or chloasma
• Freckles
• Solar or senile lentigines, often called sun spots or age spots
• Other unwanted areas of melanin-related hyperpigmentation where hydroquinone has been prescribed

Not every type of skin discolouration is caused by excess melanin or is suitable for treatment with hydroquinone. The cause and proposed treatment area should therefore be assessed before use.

How 4% hydroquinone works

Hydroquinone acts on the process through which melanocytes produce melanin. The prescribing information states that topical hydroquinone inhibits the enzymatic oxidation of tyrosine to 3,4-dihydroxyphenylalanine, also known as DOPA, and suppresses other melanocyte metabolic processes.

This produces a gradual and reversible reduction in pigmentation within the treated area. Exposure to sunlight or ultraviolet light can sustain melanocyte activity and contribute to repigmentation, which is why daily sun protection is an important part of hydroquinone treatment.

Obagi Clear #3 and Clear Fx are different formulations

Obagi Nu-Derm Clear #3 is the prescription formulation containing hydroquinone USP 4%. Obagi Nu-Derm Clear Fx is a separate hydroquinone-free cosmetic product. The names are similar, but the formulations, active ingredients and regulatory status are not interchangeable.

Formulation and ingredients

Active ingredient: Hydroquinone USP 4% (40mg/g).

The prescribing label for the 57g Obagi Nu-Derm Clear bottle lists the following inactive ingredients:

Water, cetyl alcohol, glycerin, sodium lauryl sulfate, stearyl alcohol, lactic acid, tocopheryl acetate, ascorbic acid, sodium metabisulfite, disodium EDTA, methylparaben, BHT, propylparaben, saponins and butylparaben.

Manufacturers can update formulations and labelling. Anyone with a known ingredient sensitivity should check the ingredient information supplied with the current bottle before applying the product.

How Obagi Nu-Derm Clear is applied

Use Obagi Nu-Derm Clear only according to the directions provided with your prescription. The manufacturer’s prescribing information states that a thin application may be applied once or twice daily, or as directed by the prescribing clinician.

• Apply only to the intended treatment area.
• Treatment should be limited to relatively small areas at one time.
• Avoid contact with the eyes, nose, mouth and lips.
• If accidental contact occurs, rinse the area thoroughly with water.
• Use appropriate sunscreen and protective measures during treatment and afterwards to reduce ultraviolet exposure and repigmentation.

The directions attached to an individual prescription take precedence over general manufacturer information.

Response and treatment duration

Hydroquinone produces a gradual response rather than an immediate change in pigmentation. The current prescribing label states that treatment should be discontinued if no improvement is seen after three months. The appropriate treatment duration, review point and maintenance plan depend on the individual prescription.

Skin sensitivity and precautions

The manufacturer advises testing for sensitivity before treatment by applying a small amount to an unbroken area of skin and checking the area within 24 hours. Minor redness may occur. Stop using the product and obtain medical advice if itching, blister formation, an excessive inflammatory response or another sign of hypersensitivity develops.

Transient redness or mild burning can occur. Occasional localised contact dermatitis has also been reported. The product contains sodium metabisulfite, which may cause allergic-type reactions in susceptible individuals; sulfite sensitivity is reported more frequently in people with asthma.

Do not use the product if you have previously experienced an allergic reaction to hydroquinone or another ingredient in the formulation. The safety of topical hydroquinone during pregnancy and in children aged 12 or under has not been established. Caution is also advised during breastfeeding.

Clinical information

The manufacturer’s prescribing information establishes the product’s active strength, labelled indications, pharmacological mechanism, administration range and precautions. It does not provide a numerical, product-specific efficacy claim for this exact formulation.

Published studies concerning hydroquinone may use different formulations, treatment combinations, study populations and endpoints. Results from an individual study should therefore not be presented as though they directly establish the expected result of Obagi Nu-Derm Clear #3 for every patient.

Storage

Store at a controlled room temperature of 15°C to 25°C and keep the bottle out of direct sunlight. Follow any additional storage information shown on the supplied packaging.

Frequently asked questions

What is Obagi Nu-Derm Clear #3?

Obagi Nu-Derm Clear #3 is a 57g prescription topical cream containing hydroquinone USP 4%. It is used for the gradual lightening of specified forms of melanin-related hyperpigmentation.

Is Obagi Clear #3 the same as Obagi Clear Rx?

Obagi Clear #3 is commonly referred to as Obagi Clear Rx because it is the prescription hydroquinone product within the Nu-Derm system. The bottle is labelled Nu-Derm Clear, number 3, hydroquinone USP 4%.

Does Obagi Nu-Derm Clear contain hydroquinone?

Yes. Obagi Nu-Derm Clear #3 contains hydroquinone USP 4%, equivalent to 40mg of hydroquinone in each gram of cream.

Is Obagi Clear #3 the same as Clear Fx?

No. Obagi Nu-Derm Clear #3 is the prescription formulation containing 4% hydroquinone. Clear Fx is a different hydroquinone-free cosmetic formulation.

What does hydroquinone 4% mean?

A 4% concentration means that each gram of the cream contains 40mg of hydroquinone. It does not mean that the product contains 40% hydroquinone.

What is Obagi hydroquinone cream used for?

The manufacturer’s label describes use for gradually lightening hyperpigmented conditions such as melasma, chloasma, freckles, solar or senile lentigines and other unwanted areas of melanin hyperpigmentation.

How often is Obagi Nu-Derm Clear applied?

The prescribing information states that a thin application may be used once or twice daily, or as directed by a clinician. Follow the application frequency stated on your individual prescription.

How long does Obagi Clear #3 take to work?

The response to topical hydroquinone is gradual and varies according to the condition being treated and the individual skin response. The manufacturer states that use should be discontinued if no improvement is seen after three months.

Why is sunscreen important when using hydroquinone?

Ultraviolet exposure can sustain melanocyte activity and encourage pigmentation to return. Sunscreen and other protective measures are therefore an important part of treatment during and after hydroquinone use.

Can Obagi Nu-Derm Clear be used with tretinoin?

Hydroquinone and tretinoin may be prescribed within the same skincare programme, but they should not be combined, layered or applied on the same schedule unless this has been specifically directed. The order, frequency and treatment areas depend on the individual prescription.

What should I do if Obagi Clear causes irritation?

Mild transient redness or burning can occur. Stop applying the product and seek advice if there is itching, blistering, excessive inflammation, persistent irritation or another suspected allergic reaction.

Further ingredient information

Hydroquinone: UK status, formulations and product information