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Not following these protocols can result in ineffective or contaminated results just like a restaurant serving spoiled food would lead to poor customer experiences
Prescribers can adjust hydroquinone beyond the commercial 4% ceiling (up to 8% for refractory cases), swap the steroid component based on patient sensitivity, add tranexamic acid or cysteamine for resistant pigmentation, and choose vehicle bases optimized for different skin types and climates
Frequency depends on individual goals
Neurological issues like neuropathy may take longer, up to 3-6 months (Carmel, 2008)
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