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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?
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.
What is hydroquinone used for?
Hydroquinone can address the following skin conditions related to hyperpigmentation.
- Age spots/sun spots
- Post-inflammatory hyperpigmentation
- Evening skin tone
- Freckles (small, brown spots caused by sun exposure and genetics)
- Hyperpigmented acne scars
How to get a prescription for hydroquinone?
To get treatment for hyperpigmentation, you can do a photo-consultation with a dermatology provider in your state for only $59. You need to take some photos of your skin and answer the questions in the app, which takes less than 5 minutes. You will get an answer in 1-2 days together with your prescription.
Request a prescription for hydroquinone!
Why is hydroquinone so widely used for melasma?
According to Dr. Mohta, hydroquinone 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.
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.
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.
Hydroquinone is available in different formulations, including creams, gels, and lotions, making it suitable for various skin types and preferences.
Adverse reactions associated with hydroquinone
- 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
How long can I use hydroquinone?
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?
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.
Are there other ingredients used to treat melasma?
Yes, besides hydroquinone, there are many other excellent ingredients used to treat skin pigmentation and lighten your skin. Usually the most effective treatments are a combination of ingredients that tackle the problem from a different area such as: retinoids (tretinoin or tazarotene), azelaic acid, tranexamic acid, kojic acid and vitamin C.
Hydroquinone is a powerful ingredient that is very effective for melasma and other skin pigmentation problems, but it should only be used under medical supervision and for a limited period of time. Your online dermatology provider will help you get the best results for your skin condition so you can obtain the bright complexion you desire.
If your melasma, es quite severe, you can also find a dermatology provider in your city and consider doing chemical peels or laser treatment at the local clinic.
Request an tretinoin and hydroquinone prescription for melasma!