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Imiquimod: is an immune response modi!er that increases local cytokine production, which activates both the innate and adaptive immune systems. Imiquimod demonstrates antiviral potency topically, helps stimulate the body’s adaptive immune response by acting on Langerhans cells in the epidermis, and has shown antitumor activity from cell-mediated immune response.
Tretinoin: Retinoids, such as vitamin A and retinoic acid (RA) or tretinoin, were first used in combination with Hydroquinone to enhance the penetration of Hydroquinone (Klingman and Willis, 1975). The ability of tretinoin to depigment is based on its ability to disperse keratinocyte pigment granules, interfere with pigment transfer, and accelerate epidermal turnover and, therefore, pigment loss.