CLINICAL PHARMACY EVALUATION OF IRRITANT CONTACT DERMATITIS ASSOCIATED WITH FACIAL WHITENING CREAM USE IN AN AESTHETIC CLINIC: A CASE REPORT

Abstract

Background Facial whitening creams containing active ingredients such as tretinoin, hydroquinone, and topical corticosteroids are commonly prescribed in aesthetic clinics for the management of hyperpigmentation and skin rejuvenation. Although generally effective, inappropriate use or individual intolerance may lead to adverse cutaneous reactions, including irritant contact dermatitis. Reporting such cases is important to highlight the role of clinical pharmacy services in identifying, assessing, and managing cosmetic-related adverse reactions. Case Summary A 28-year-old female presented to an aesthetic clinic with complaints of facial erythema, burning sensation, skin dryness, and desquamation that developed after two weeks of regular use of a prescribed facial whitening cream. The patient had no previous history of dermatological disorders, allergies, or chronic illnesses. Symptoms progressively worsened despite continued application of the product. Investigation and Diagnosis Clinical assessment revealed diffuse facial erythema and mild scaling without signs of infection or systemic involvement. A comprehensive medication and cosmetic use history was obtained by the clinical pharmacist. Differential diagnoses included allergic contact dermatitis, rosacea, and irritant contact dermatitis. Based on the temporal relationship between symptom onset and product use, clinical manifestations, and symptom improvement after discontinuation, the condition was diagnosed as irritant contact dermatitis associated with facial whitening cream use. Causality assessment using the Naranjo Adverse Drug Reaction Probability Scale indicated a probable association. Management The whitening cream was temporarily discontinued. Supportive management included the use of a ceramide-based moisturizer and broad-spectrum sunscreen (SPF 50+). The patient received pharmacist-led counseling regarding skin barrier protection, gradual reintroduction of active topical agents, and recognition of potential adverse reactions. Follow-up monitoring was conducted to evaluate treatment response. Outcome Clinical improvement was observed within seven days, with a reduction in erythema and burning sensation. At the two-week follow-up, skin irritation had substantially resolved, and no further complications were reported. The patient successfully resumed a modified skincare regimen under professional supervision. Conclusion This case emphasizes the importance of clinical pharmacy involvement in cosmetovigilance and the management of cosmetic-related adverse skin reactions. Early identification, causality assessment, patient education, and appropriate therapeutic interventions can improve patient safety and treatment outcomes in aesthetic practice.