Pigmanorm

Pigmanorm is used to treat melasma.

What is Pigmanorm?

Pigmanorm is a cream that is used on skin affected by melasma, a condition caused by hyperpigmentation of the skin that makes the facial skin appear darker.

Pigmanorm contains three active ingredients, tretinoin, hydrocortisone and hydroquinone, which work together to reduce the amount of pigment in the skin and the visibility of the darker skin patches.

Tretinoin is a retinoid, which is derived from vitamin A. Tretinoin works by increasing the rate of skin cell turnover. Hydrocortisone is a topical corticosteroid that works as an anti-inflammatory agent, reducing skin inflammation. Hydroquinone is a skin lightening agent. It works by interfering with the production of the skin pigment melanin by melanocytes, which leads to a decrease in melanocytes numbers. The cream contains tretinoin 0.1% w/w, hydrocortisone 1% w/w, and hydroquinone 5% w/w.

Can I buy Pigmanorm online?

The Online Clinic can prescribe Pigmanorm for Melasma. Please complete the consultation form to begin.

How to use Pigmanorm

Before using Pigmanorm, wash the hyperpigmented skin area to be treated. Then, evenly massage a small amount (size of a pea) into the that skin area and the immediately surrounding skin using a fingertip. The eyes, mucous membranes of the mouth and nose should be avoided. Avoid washing the treated area immediately after application, and using other skin products on treated skin unless directed by a doctor.

The amount of Pigmanorm used, when it is used, how often it is used and how long it is used will be decided by the consulting doctor. Note that use of more than a small amount of cream will not work faster or better but can irritate the skin. Pigmanorm is usually used once daily, about half an hour before you go to bed, for no more than 8 weeks at any one time. However, because Pigmanorm cream can be an irritant, the skin may need to build up tolerance to the cream. Tolerance is built up by gradually increasing use of the cream. The doctor may advise to firstly use the cream intermittently, such as for a few hours a day or two nights a week only for two weeks. Then its use will be gradually increased, until finally, it will used every night, or as advised by the doctor. If the skin becomes inflamed, Pigmanorm should not be used until the skin has healed completely. Skin reactions usually settle after a few days when use of the cream can be restarted.

Products that can irritate the skin, such as soaps, peels and cleaning agents, and exposure to sunlight (by sun avoidance and using a SPF sunscreen of 30 or higher) should be avoided. It is advisable to stop using Pigmanorm one or two weeks before going to a hot sunny country; it can be started cautiously again on return.

If a dose is missed, Pigmanorn should be used as soon as possible unless it is close to the time of the next dose. In that case, skip the missed dose and apply treatment according to the dosing schedule and at the advised dose. If too much Pigmanorm is used, seek medical advice.

Who can use Pigmanorm?

Pigmanorm can be used by people with melasma who are 5 years of age or older. It should not be used by women who are pregnant or breastfeeding.

Pigmanorm must not be used by people who are hypersensitive to any of the product’s ingredients, including tretinoin, hydrocortisone and hydroquinone. It must be stopped immediately and a doctor informed if signs of an allergic reaction occur, such as hives, problems breathing, and/or swelling of the face, facial features, tongue or throat.

It is important to tell the doctor about any medical conditions that you have. Pigmanorm should not be used on eczematous, inflamed, injured or burnt skin, or by anyone with rosacea, epilepsy, Addison's disease, osteoporosis, and/or rectal disease.

Additionally, it is important to tell the doctor about any medicines or heath products that you use. Other medicines, including over the counter medicines or heath products, may affect the way Pigmanorm works or Pigmanorm may affect the way other medicines/heath products work. Interactions may occur with alcohol, vitamin C, aspirin, amphotericin B, gentamicin, benzoyl peroxide, aminoglutethimide, amobarbital, carbamazepine, and furosemide.

Pigmanorm side effects

Pigmanorm may inflame or irritate the skin, causing a burning sensation or skin to become dry, red, itchy, or peel. Rarely, irritation may be prolonged or severe, skin swollen or discoloured (blue-black); eyes, nose or mouth may be irritated; and or breathing difficult. If any of these signs occur, Pigmanorm must be stopped and a doctor contacted. Pigmanorm may also cause other side-effects; if concerned, discuss any signs or symptoms with a doctor.

References

Kang HY, Valerio L, Bahadoran P, Ortonne JP. The Role of Topical Retinoids in the Treatment of Pigmentary Disorders. An Evidence-Based Review. Am J Clin Dermatol 2009; 10 (4) Rajaratnam R, Halpern J, Salim A, Emmett C. Interventions for Melasma. Published 07/07/2010.
Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003583.pub2/full

Reviewed by: Dr Loraine Haslam MBBS, DRCOG, DFSRH, LoC SDI, LoC IUT, MRCGP
GMC registration number: 4524038
Date: 23 January 2024
Next review: 22 January 2026
All UK registered doctors can have their registration checked on
The Medical Register at the GMC website.