Hydroquinone

Authors: Drs. Lulit Price, Neelam Vashi, and Nkanyezi Ferguson

What is hydroquinone?
Hydroquinone is a topical cream that is used to lighten dark patches of the skin (also called hyperpigmentation). It is available as a prescription alone and as a combination cream containing a topical steroid and a topical retinoid. In some countries, including the United States, it is available over the counter, most often in a 2-3% formulation. 

What is hydroquinone used for?
Hydroquinone is used to lighten dark patches of the skin. These dark spots can be related or triggered by many factors including pregnancy, birth control pills, inflammation, and injury to the skin.  The most common use is for melasma, a condition in which people develop dark patches on the face and other areas of skin, such as the arms.

How is it used?
Safe use of hydroquinone includes using it under the supervision of a dermatologist. It should be applied only to the affected darkened areas of skin to avoid lightening of normal skin. It should not be used for extended periods of time as it can cause a paradoxical darkening.  Cycling of use with breaks is recommended to limit overuse and the side effect known as exogenous ochronosis.  

What else do I need to know about hydroquinone?
It is an out of pocket expense as insurance will not cover this medication. If using it to treat melasma, it should be used in combination with a broad-spectrum sunscreen SPF 30 or higher daily. Sunscreen should be applied to the affected areas after hydroquinone to avoid relapse of the condition. Dark areas may recur if the cream is discontinued but this is less likely happen if sun protective measures are followed.

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Education Video Library

• Did You Know? Hyperpigmentation, Hydroquinone and Helping Patients with Skin of Color
• Doctor-to-Doctor: The Straight Scoop on Hydroquinone