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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Remove Black Milk Cream
Generic Name
Remove Black Milk Cream
Active Ingredient
ArbutinCategory
Adenosine Receptor Agonist [EPC]
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 3 mg/100mL | CREAM | CUTANEOUS | 84025-307 |
Detailed information about Remove Black Milk Cream
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Remove Black Milk Cream, you must consult a qualified healthcare professional.
Arbutin is a glycosylated hydroquinone derivative classified as an Adenosine Receptor Agonist and Vitamin C derivative, primarily utilized in dermatology for its potent skin-lightening and anti-inflammatory properties.
For the treatment of hyperpigmentation and melasma in adults, the standard dosage of Arbutin depends heavily on the isomer used (Alpha vs. Beta) and the formulation concentration.
In clinical practice, a 'pea-sized' amount is often sufficient for the entire face. If using a spot treatment, only a small drop should be applied directly to the hyperpigmented lesion. Healthcare providers often recommend a 'cycling' approach—using the product for 3 to 4 months followed by a break—to prevent the development of resistance or rare side effects like ochronosis.
Arbutin is generally not approved for pediatric use. The safety and efficacy of skin-lightening agents in children under the age of 18 have not been established. Hyperpigmentation in children is often treated with milder alternatives or by addressing the underlying cause (e.g., sun protection or treating active eczema). If a healthcare provider deems it necessary for an adolescent, it is used with extreme caution and under strict dermatological supervision.
Since topical Arbutin has minimal systemic absorption, dose adjustments for patients with mild to moderate renal impairment are typically not required. However, in patients with end-stage renal disease (ESRD), caution is advised if applying to large surface areas of broken skin, as systemic accumulation of the hydroquinone metabolite could theoretically occur.
No specific dosage adjustments are documented for hepatic impairment due to the localized nature of the drug. However, patients with severe liver failure should be monitored if they are using high concentrations over extensive body areas, as the liver is responsible for detoxifying any hydroquinone that reaches the bloodstream.
Elderly patients often have thinner skin (atrophy), which may increase the rate of absorption. It is recommended to start with a lower concentration (e.g., 1% Alpha-Arbutin) or a once-daily application to assess skin tolerance before moving to a standard twice-daily regimen.
Arbutin must be used correctly to ensure safety and effectiveness:
If you miss an application of Arbutin, apply it as soon as you remember. However, if it is almost time for your next scheduled application, skip the missed dose and resume your regular routine. Do not 'double up' on the amount of product to make up for a missed dose, as this increases the risk of localized skin irritation.
An 'overdose' of topical Arbutin usually manifests as severe localized skin irritation. Symptoms may include intense redness, burning, itching, or peeling. In rare cases of accidental ingestion, seek emergency medical attention immediately. Signs of systemic hydroquinone toxicity include tremors, cyanosis (blue-tinted skin), and convulsions. If a large amount is swallowed, contact a poison control center or go to the nearest emergency room.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose or frequency of application without medical guidance.
Most patients tolerate Arbutin well, but because it is an active pharmacological agent, some localized reactions are common, especially during the first two weeks of treatment. These include:
> Warning: Stop taking Arbutin and call your doctor immediately if you experience any of these serious reactions.
The long-term safety of Arbutin beyond 12 months of continuous use has not been extensively studied in large-scale clinical trials. Potential long-term effects include:
No FDA black box warnings for Arbutin. Unlike some systemic medications or older formulations of hydroquinone that were restricted due to carcinogenic concerns in animal models, Arbutin is generally recognized as safe (GRAS) for topical cosmetic and dermatological use when used as directed. However, regulatory bodies in the European Union and other regions strictly limit the concentration of Alpha-Arbutin to 2% in face creams and 0.5% in body lotions to ensure safety.
Report any unusual symptoms or persistent irritation to your healthcare provider. Monitoring by a dermatologist is recommended for long-term therapy.
Arbutin is a potent biochemical agent that requires careful handling. It is essential to understand that Arbutin is a derivative of hydroquinone. While it is safer and more stable, it shares some of the same clinical precautions. Patients with a history of sensitive skin or multiple drug allergies should perform a 'patch test' (applying a small amount to the inner forearm for 48 hours) before full facial application. Arbutin should never be applied to open wounds, infected skin, or areas with active rashes.
Currently, there are no FDA black box warnings for Arbutin. It is classified as a cosmetic active or a topical dermatological agent depending on the concentration and the region of sale.
For patients using clinical-strength Arbutin (especially in combination with other agents like tretinoin or steroids), the following monitoring is recommended:
Topical Arbutin has no known effect on the central nervous system and does not impair the ability to drive or operate heavy machinery.
There are no direct contraindications between topical Arbutin use and moderate alcohol consumption. However, alcohol can cause vasodilation (widening of blood vessels) and skin flushing, which might temporarily increase the sensation of stinging or redness in patients already experiencing mild irritation from Arbutin.
There is no 'withdrawal syndrome' associated with stopping Arbutin. However, hyperpigmentation often returns if the underlying cause (such as sun exposure or hormonal fluctuations) is still present. It is generally recommended to taper use from twice daily to once daily, then to three times a week, rather than stopping abruptly, to maintain results.
> Important: Discuss all your medical conditions, including any history of skin cancer or chronic inflammatory skin diseases, with your healthcare provider before starting Arbutin.
Arbutin should not be used concurrently with other products containing Hydroquinone unless specifically directed by a dermatologist. Since Arbutin is a hydroquinone derivative, using both simultaneously can lead to an 'overdose' at the melanocyte level, significantly increasing the risk of skin toxicity, permanent hypopigmentation, or ochronosis.
There are no known interactions between topical Arbutin and specific foods. Unlike some oral medications, Arbutin's efficacy is not affected by the consumption of grapefruit, dairy, or high-fat meals. However, a diet high in antioxidants may theoretically support the drug's overall goal of reducing oxidative stress in the skin.
Arbutin is not known to interfere with standard blood or urine laboratory tests. However, if Arbutin is being used systemically (which is rare and usually only in research settings), it may cause a false-positive result in urine tests for ferric chloride (used to detect certain metabolic disorders) due to the phenolic nature of its metabolite, hydroquinone.
Mechanism of Interactions: Most interactions with Arbutin are pharmacodynamic (additive effects on skin irritation) rather than pharmacokinetic (changes in metabolism). The primary risk is the destabilization of the Arbutin molecule, leading to premature hydroquinone release.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, including those applied to the skin.
Arbutin must NEVER be used in the following circumstances:
Conditions requiring a careful risk-benefit analysis include:
Patients who are sensitive to other phenolic compounds (such as resorcinol, catechol, or certain preservatives like parabens) may exhibit cross-sensitivity to Arbutin. If you have reacted to other skin-lightening agents or chemical dyes in the past, a medically supervised patch test is mandatory.
> Important: Your healthcare provider will evaluate your complete medical history, including any history of 'chemical sensitivity,' before prescribing or recommending Arbutin.
Arbutin is generally classified as Category C (or the equivalent in various international systems). This means that animal reproduction studies have shown an adverse effect on the fetus, and there are no adequate and well-controlled studies in humans. Because Arbutin is a derivative of hydroquinone, and hydroquinone has a relatively high systemic absorption rate (up to 35-45%) when applied topically, most dermatologists recommend avoiding Arbutin during pregnancy. The primary concern is the potential for hydroquinone to interfere with fetal development, although no specific human teratogenicity has been proven.
It is unknown whether topical Arbutin or its metabolites are excreted in human milk. However, many drugs are excreted in breast milk, and the risk of the infant ingesting the product through skin-to-skin contact with the mother's treated skin is significant. If Arbutin must be used, it should not be applied to the breast or chest area, and the mother should wash her hands thoroughly before handling the infant.
As previously noted, Arbutin is not recommended for children. The skin of infants and young children is more permeable and has a higher surface-area-to-body-mass ratio, which significantly increases the risk of systemic absorption and toxicity. There are no clinical trials establishing a safe age for the commencement of Arbutin therapy.
In elderly patients, the primary concerns are skin fragility and polypharmacy. Older adults are more likely to be using multiple topical medications (e.g., steroid creams for thinning skin or topical NSAIDs). The risk of 'additive irritation' is high. Furthermore, reduced renal clearance in the elderly means that in the unlikely event of systemic absorption, the hydroquinone metabolites may take longer to clear from the body. Providers should monitor for signs of 'thinning skin' or easy bruising at the application site.
Patients with impaired kidney function (GFR < 60 mL/min) should use Arbutin with caution over large surface areas. While topical use is generally safe, the kidneys are the primary route for the elimination of phenolic metabolites. In patients on dialysis, the clearance of hydroquinone is not well-documented, making conservative use essential.
In patients with significant hepatic impairment (Child-Pugh Class B or C), the liver's ability to conjugate hydroquinone (via glucuronidation) may be reduced. This could theoretically lead to higher levels of free hydroquinone in the blood. While this is a low risk for topical application, these patients should be monitored for systemic symptoms like fatigue or jaundice, which could be exacerbated by phenolic load.
> Important: Special populations require individualized medical assessment. Always inform your specialist if you fall into any of these categories.
Arbutin's molecular mechanism is centered on its role as a competitive inhibitor of tyrosinase. Tyrosinase is a multi-functional copper-containing oxidase. Arbutin competes with the natural substrate L-DOPA for the active site of the enzyme. Specifically, the phenolic group of the hydroquinone moiety within Arbutin mimics the structure of tyrosine. By occupying the active site, Arbutin prevents the enzyme from converting L-DOPA into dopaquinone, thereby halting the melanin synthesis pathway. Additionally, as an Adenosine Receptor Agonist, Arbutin binds to A1 and A2A receptors on the surface of skin cells. This binding triggers an intracellular cascade that reduces the production of pro-inflammatory cytokines (like IL-1 and TNF-alpha) and decreases the expression of melanocyte-stimulating hormone (MSH), further down-regulating pigment production.
The pharmacodynamic effect of Arbutin is dose-dependent. Higher concentrations (up to the safety limit of 2% for Alpha-Arbutin) result in greater tyrosinase inhibition. The onset of action is slow; while enzyme inhibition begins immediately upon penetration, visible changes in skin color require the natural turnover of the epidermis (approximately 28 to 40 days) to shed existing pigmented cells. The duration of effect lasts as long as the drug is consistently applied. Once discontinued, tyrosinase activity returns to baseline, and melanin production resumes.
| Parameter | Value |
|---|---|
| Bioavailability | 1-5% (Topical, intact skin) |
| Protein Binding | 30-40% (Albumin) |
| Half-life | 2-4 hours (Skin); 1.5 hours (Plasma) |
| Tmax | 4-8 hours (Topical application) |
| Metabolism | Hydrolysis to Hydroquinone; Hepatic Glucuronidation |
| Excretion | Renal 90%+, Fecal <5% |
Arbutin is classified as a Glycosylated Hydroquinone Derivative. Within the therapeutic hierarchy, it is an Adenosine Receptor Agonist [EPC] and is often grouped with Vitamin C [EPC] due to its role in redox signaling and antioxidant defense. It is related to other skin-lightening agents like Kojic Acid, Azelaic Acid, and Hydroquinone.
Common questions about Remove Black Milk Cream
Arbutin is primarily used as a skin-lightening agent to treat various forms of hyperpigmentation, including melasma, age spots, and post-inflammatory hyperpigmentation from acne. It works by inhibiting the enzyme tyrosinase, which is responsible for the production of melanin, the pigment that gives skin its color. By slowing down this process, Arbutin helps to fade dark spots and create a more even skin tone. It is also valued for its anti-inflammatory properties, which can help soothe skin redness. Many dermatologists recommend it as a safer, more stable alternative to hydroquinone.
The most common side effects of Arbutin are localized to the skin and include mild redness, dryness, and a slight stinging or tingling sensation upon application. Some users may also experience minor flaking or peeling as the skin adjusts to the active ingredient. These effects are usually temporary and subside within a few weeks of consistent use. If these symptoms become severe or lead to intense itching and swelling, it may indicate an allergic reaction. Always perform a patch test before using Arbutin on your entire face.
Since Arbutin is applied topically to the skin, there is no direct interaction with alcohol consumption. You can generally drink alcohol in moderation while using Arbutin products without affecting the medication's efficacy. However, alcohol can cause skin flushing and dehydration in some individuals, which might make the skin more sensitive to the active ingredients in your skincare routine. If you notice increased redness or irritation after drinking alcohol, you may want to apply Arbutin more sparingly. Always consult your doctor if you have concerns about alcohol and your specific skin condition.
Arbutin is generally not recommended for use during pregnancy. Because it is a derivative of hydroquinone, there are concerns that a significant amount could be absorbed into the bloodstream and potentially affect fetal development. While there is no definitive evidence of harm in humans, most healthcare providers advise a 'safety first' approach and suggest switching to proven-safe alternatives like azelaic acid or glycolic acid during pregnancy. If you are pregnant or planning to become pregnant, you should discuss your skincare routine with your obstetrician or dermatologist. Always prioritize the health of the fetus over cosmetic skin treatments.
Visible results from Arbutin typically take between 8 to 12 weeks of consistent, twice-daily application. This timeline is due to the fact that Arbutin prevents the formation of *new* pigment but does not bleach existing pigment instantly. Your skin must go through several natural renewal cycles (which take about 30 days each) to shed the old, darkened cells and replace them with the newer, less-pigmented cells. Consistency is key, and the use of a broad-spectrum sunscreen is mandatory to see results. If you do not see improvement after three months, consult your dermatologist for a stronger treatment plan.
Yes, you can stop using Arbutin suddenly without experiencing any physical withdrawal symptoms or 'rebound' effects in the traditional sense. However, because Arbutin works by suppressing melanin production, stopping treatment means your tyrosinase enzymes will return to their normal activity levels. If the underlying cause of your hyperpigmentation (such as sun damage or hormonal changes) is still present, the dark spots may gradually return over several weeks. To maintain your results, it is often better to transition to a maintenance routine rather than stopping all pigment-regulating products entirely. Always use sunscreen to prevent the spots from coming back.
If you miss an application of Arbutin, simply apply it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed application and continue with your normal routine. Do not apply a larger amount of product to 'make up' for the missed dose, as this will not speed up the results and will only increase your risk of skin irritation. Consistency is more important for Arbutin's effectiveness than the exact timing of a single application. Setting a reminder on your phone can help you stay on track with your morning and evening skincare steps.
No, topical Arbutin does not cause weight gain. Because it is applied to the skin and has very limited systemic absorption, it does not enter the bloodstream in quantities large enough to affect your metabolism, appetite, or fat storage. Weight gain is not a reported side effect in any clinical studies of Arbutin or other similar tyrosinase inhibitors. If you experience unexplained weight gain while using Arbutin, it is likely due to other factors such as diet, lifestyle, or a different medication. You should consult your primary care physician to investigate any sudden changes in your weight.
Arbutin can be used alongside many other medications, but you should be cautious when combining it with other potent topical treatments. For example, using Arbutin with retinoids (like tretinoin) or strong exfoliating acids can increase skin sensitivity and lead to irritation. It should generally not be used with hydroquinone unless directed by a doctor, as they are chemically related. Always inform your healthcare provider about all the medications you use, including over-the-counter creams and supplements. They can help you create a schedule that minimizes the risk of interactions and maximizes the health of your skin.
Arbutin is not a prescription drug in the traditional sense in many countries, so the concept of 'generic' vs. 'brand name' is slightly different. It is available as a raw active ingredient used by many different skincare brands, ranging from affordable 'generic-style' clinical brands to high-end luxury labels. When shopping, look for the concentration of 'Alpha-Arbutin' or 'Beta-Arbutin' on the label to ensure you are getting an effective dose. Alpha-Arbutin is generally considered the more 'premium' and effective version. Since it is widely available from multiple manufacturers, you can find high-quality Arbutin products at various price points.
Other drugs with the same active ingredient (Arbutin)