Hydroquinone cream: Uses, Benefits and how to get it

Table of Content:
What is hydroquinone? | Is it available OTC? | How to get a prescription for melasma? | Benefits | What is the best hydroquinone cream? | How to get a customized cream? | How to use hydroquinone? | Potential side-effects

Hydroquinone is considered one of the best treatments for melasma due to its effectiveness in inhibiting melanin production and reliably improving skin tone. It has a proven track record, it is available in different formulations, and can be used in combination with other agents for enhanced results. 

In this article, Dr. Alpana Mohta, board certified dermatologist, explains why hydroquinone is so widely used in the treatment of melasma. 

What is hydroquinone cream and what is it used for?

Hydroquinone is a skin-lightening ingredient commonly used to address hyperpigmentation in the skin (such as melasma) resulting from factors like hormonal imbalance, sun damage, inflammation, and skin injuries, including those associated with acne¹.  

Hydroquinone can address the following skin conditions related to hyperpigmentation:

• Melasma
• Age spots/sun spots
• Post-inflammatory hyperpigmentation
• Evening skin tone
• Freckles (small, brown spots caused by sun exposure and genetics) 
• Hyperpigmented acne scars

Can I get hydroquinone cream over the counter (OTC)?

No, you cannot get hydroquinone cream over the counter as it is a prescription medication.

So, how to get hydroquinone cream then?

You can have a photo-consultation with a board-certified dermatologist in your state. Consultation for new patients is only $59 and for returning patients who need a refill is only $39. Take some photos of your skin and answer the questions, which takes less than 5 minutes. You will get an answer in 1-2 days together with your prescription.

What are the benefits of using hydroquinone cream for melasma?

According to Dr. Mohta, hydroquinone cream is widely used to treat melasma and other hyperpigmentation conditions due to its skin bleaching properties. It has many benefits including the efficacy of treating the condition to the variety of formulations and strengths available to suit your individual needs. 

Inhibits melanin production

Hydroquinone is a skin-lightening agent that works by inhibiting the activity of tyrosinase, an enzyme involved in melanin production. By reducing melanin synthesis, it can help lighten and fade hyperpigmented areas, which is a key goal in treating melasma².

Proven track record

Hydroquinone has a long history of use in dermatology and has been widely studied for its effectiveness in treating melasma. It has consistently demonstrated positive results in clinical trials and real-world applications³.

Reliable and predictable results

Hydroquinone tends to produce reliable and predictable results in many cases of melasma. It is often effective in reducing the appearance of dark patches and improving overall skin tone when used as directed. It takes around 4 weeks to see visible differences in your hyperpigmentation, however, in order to see full results you need to use it consistently for 3 months⁴.

Combination therapy

Hydroquinone can be employed in compound medications alongside tretinoin or as part of a triple combination therapy by incorporating topical steroids (marketed as Tri-Luma). This approach significantly boosts its efficacy in addressing melasma and is commonly known as triple combination therapy⁵.

Availability

Due to the concerns related to long-term use of this product, Hydroquinone is not available over the counter (OTC) it was banned by the FDA as an OTC product in 2020. However, hydroquinone cream 2% and 4% can be obtained with a doctor’s prescription.

Formulations

Hydroquinone is available in different formulations, including creams, gels, and lotions, making it suitable for various skin types and preferences.

What is the best hydroquinone cream?

Dr. Mohta says that hydroquinone cream is a powerful and effective treatment for melasma, hyperpigmentation, and dark spots. However, the most effective option is often a customized, compounded cream designed by a dermatologist. These formulas may combine hydroquinone with tretinoin and a mild corticosteroid, creating a synergistic blend that targets dark spots more effectively and delivers faster results.

Can I get a customized hydroquinone formula via Miiskin?

Yes, when you are doing your online consultation with a dermatologist via Miiskin, mention that would you like to get a customized formula for dark spots and your dermatologist will carefully select the best ingredients for your problem and your type of skin.

How long can I use hydroquinone cream for?

Dr. Mohta says that hydroquinone should only be used for up to 3 months at a time⁷.  However, as a maintenance treatment for melasma, you can switch to using other ingredients such as tretinoin and azelaic acid (which is also a skin lightening ingredient) which can be used long term.

How to use hydroquinone cream?

Dr. Mohta says that you should always follow your dermatologist’s instructions regarding the frequency of application, which is typically, once daily, as a general rule you should follow the steps listed below.

Cleanse your skin

Wash your face or the affected area gently with a mild, soap-free cleanser. Pat your skin dry with a clean towel. Make sure your skin is completely dry before applying hydroquinone.

Apply a thin layer

Using clean fingertips, apply a thin layer of hydroquinone cream or gel to the areas you wish to treat and gently massage the product into your skin until it is evenly distributed. Avoid getting hydroquinone near your eyes, mouth, and mucous membranes.

Use sun protection

Apply a broad-spectrum sunscreen with a high SPF (SPF 50) daily, especially in the morning as UV exposure can worsen hyperpigmentation and counteract the effects of hydroquinone.

Use a moisturizer

It is likely that your skin will become dry or irritated during treatment, apply a non-comedogenic, gentle moisturizer to soothe your skin.

Monitor your skin

Pay attention to your skin’s response to hydroquinone. If you experience excessive irritation, redness, or any adverse reactions, discontinue use and consult your healthcare provider.

Schedule follow-up appointments

Schedule follow-up appointments with your online dermatologist to assess your progress and make any necessary adjustments to your treatment plan.

Discontinue when instructed

Remember that hydroquinone cannot be used long-term. You should stop using the treatment whether it works or not after a maximum of 3 months. Talk to your dermatologist about getting a maintenance plan to prevent the dark spots from coming back.

Always do a patch test before starting hydroquinone

A patch test for hydroquinone is essential to check for skin reactions before broader usage. Apply a small amount to a small skin area and monitor for any adverse reactions like redness or irritation over the next 24 hours. This test helps identify potential allergies or sensitivities to hydroquinone, ensuring safer use. Consulting a dermatologist before conducting the test is advisable for proper guidance.

What are the potential side-effects associated with the use of hydroquinone cream?

• Skin dryness, peeling, itching, or a burning sensation
• Thinning of the skin, making it prone to easy bruising
• Darkening of the natural skin color
• Scaling in the vicinity of the mouth
• Skin blistering, crusting, or flaking
• Redness, irritation, or the development of rashes
• Lightening of the normal skin tone
• Intense redness, soreness, or extensive skin scaling⁶

References:
https://www.ncbi.nlm.nih.gov/books/NBK539693/
https://www.ncbi.nlm.nih.gov/books/NBK539693/
https://pubmed.ncbi.nlm.nih.gov/12709008/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800888/
https://my.clevelandclinic.org/health/drugs/19764-hydroquinone-skin-cream-gel-emulsion-lotion-or-solution
https://www.sciencedirect.com/topics/medicine-and-dentistry/hydroquinone

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