Everything You Need To Know About Hydroquinone for Hyperpigmentation: The Good, The Bad & The Ugly!

[@profmj7630]

Great video. My doc prescribed me a mixture of hydroquinone, tretinoin, niacinamide and kojic acid cream. I love how its fading my dark circles. I definitely wear a sunscreen now once I started it. Most of my hyperpigmentation is due to sun damage or acne scars. My doctor did say 6 weeks use it and 2 weeks take a break.

[@CitySkinClinic]

Thanks for sharing your journey! I’m so glad that combination is already working and your doctor’s advice sounds excellent. It really highlights the importance of having both the treatment and protocol personalised for you and I suspect it’s why you’re already seeing good results. Good luck with the treatment and please send an update when you’re done ☺️

[@rvmg6297]

Did you experience redness? I am asking because I did. I am scared to apply it again.

[@profmj7630]

@rvmg6297 initially, I did but I had to change my facial wash and moisturizer. Now, I use vanicream facial wash and vanicream facial moisturizer with hyaluronic acid. So at night, I wash my face, next apply the hydroquinone mix, last step is the moisturizer. I don't do any other serums or retinols on the area I apply it to.

[@rvmg6297]

@@profmj7630 I use cetaphil gentle cleanser and cetaphil PM moisturizer. Is this gonna go away? And also can I still use my tretinoin at night?

[@AdarshSingh-hd4qj]

My doc is prescribed hydroquinone 4% for tanning ande its realy help me after 6 months of treatment he say to used it life time with tretenion.5% does it safe for life time use or it causes ochrnosis

[@CitySkinClinic]

Hi Adarsh, thanks for sharing. I’m so glad that the Hydroquinone helped but I would definitely clarify with your doctor regarding the long term plan. Whilst Tretinoin can be used for long term maintenance (as long as there are no contraindications) hydroquinone should not be used for long periods without breaks otherwise there’s a risk of ochronosis. Please check with your doctor what the exact plan is and if they will introduce breaks or if this is for a limited period.

[@romatravellergirl3530]

I have been using obagi blender and tretinoin 0.1% for ten years! My nurse prescriber said it was safe… I feel so worried now

[@CitySkinClinic]

Hi there Tretinoin can be used long term if no contraindications like pregnancy, breast feeding etc. If the Obagi blender is the fx (Arbutin version) then that can also be used long term. If however it is the Hydroquinone version then that can’t be used for more than 6 months continuously. You need to speak with your prescriber and clarify.

[@aptl]

Thanks for the video. How effective has it been for undereye / upper lip pigmentation? Are there risks that pigment comes back worse once you stop using it? Thanks!

[@CitySkinClinic]

Really good question so thanks for asking! Wouldn’t normally recommend using in the under eye area (apart from some exceptions) and for the lips it can be effective depending on the type of hyperpigmentation, where it is in the lip and quality of the lip tissue. If used as part of a targeted treatment plan (with an exit/maintenance program) then the risk of it coming back or worsening can be massively reduced. I’ve written a detailed guide to this on our blog cityskinclinic.com/hyperpigmentation-lips-treatment/

[@tyufifyfitd]

i have severe discoloration around my mouth, but everyone says it’s not okay to put it around the mouth…

[@CitySkinClinic]

There are lots of possible treatments for perioral hyperpigmentation and hydroquinone is one of them. However it really depends on the type of hyperpigmentation, your skin type and also the formulation of the product. So if appropriate your doctor can provide you with a hydroquinone protocol to use in that area but an assessment is needed and also careful monitoring to ensure that your skin responds properly and you use it correctly.

[@tyufifyfitd]

@ thank you so much!

[@rvmg6297]

I had redness the next morning I applied hydroquinone. My derm prescribed me hq8% niac5%kojic acid 6% compounded. I am scared to use it again. I will just azelaic acid or alpha arbutin. I don't want to add more pigment on my skin.

[@CitySkinClinic]

Sorry to hear about your skin reaction and hope it’s better! It sounds like irritation but could also be allergy. The hydroquinone content is high and might be causing a lot of the irritation although it could also be due to the other ingredients if you haven’t used then before. It’s worth speaking with your Derm as you might tolerate starting with a lower strength first and gradually build up to that or they might remove some of the other ingredients in the compounded formula. Alternatively they may advise on a protocol that reduces some of this absorption initially (e.g sandwich method etc). Ultimately if it is an allergy or your skin can’t tolerate it then over the counter products may be best.

[@rvmg6297]

@@CitySkinClinic Thank you for your response. I sent my pictures to my derm and she said that my skin is adjusting and it is not a bad irritation. My skin is adjusting to it. Hopefully she is right. I git scared so I stopped using it after I applied it the first time.

[@CitySkinClinic]

That’s awesome news! You did the right thing to stop using and check with your Derm. That’s what we always recommend our patients do and then we can advise them on whether to continue or change protocol etc. I hope it settles down soon for you ☺️

[@nadinelubs]

Welcome back dr Amel… thanks for clarifying why & how to best use it. It worked for me, whilst i was under your care. I Cleared my post inflammatory hyper pigmentation very well. It’s true when you have guidance, your skin improves… please do a video on body sunscreen. We all know about protecting our faces, but very little recommandation on sunscreen for the body.🙂

[@CitySkinClinic]

Thanks Nads! really appreciate your support as always 😊 It was such a delight to see in the virtual clinic. You also had great results because you were very diligent with the protocols and patient too! Thanks for the great suggestion! I will do a body sunscreen video and put it up.

[@shiwanjalikawale1600]

i have used hydroquinone 4%, for an year continuosly. under derma i stopped using it in December. didnt got rebound pigmentation. bt during early march i got inflammation because of some allergy to colors of holi and got pigmentation and acne . when to derma he prescribed hydroquinone again. after using for month i requested to give me hydroquinone free product. he gave kojic cream and tretinone 3 months and seeing very less results . will i get my natural skin colour back?

[@CitySkinClinic]

So sorry to hear what you've been through but rebound hyperpigmentation can happen on hydroquinone usually if your skin is exposed to the sun. Rest assured though! You will eventually get your skin colour back. Just follow what your Derm is recommending. It will take longer because Kojic acid is a very weak pigment suppressor compared with Hydroquinone. It does work though and the Tretinoin will help it. Please make sure you protect your ski from the sun and avoid anything that can irritate it.

[@taniasara867]

Hi Dr Amel. Thanks for this informative video. I have been using Obagi Nuderm Clear with hydroquinone since last Autumn for hyperpigmentation on my face. Now my face is much lighter than my neck and one area of pigmentation is still visible on my forehead. Should I stop using it all over my face and just focus on the dark patch now and how long shall I do that?

[@CitySkinClinic]

You’re super welcome Tania ❤️ you should reach out to your doctor asap to check why the dark patch hasn’t responded and also to prevent you from over treating your face which carries risk of ochronosis. They may need to amend your protocol, stop the hydroquinone and/or taper it down.

[@easy8figure]

hello doc i want to remove the tan on my face so i want to add hydroquinone 4 percent..im a fitzpatrick 4 and my original tone was a 3...now i already use tretinoin 0.025..so i how should i incorperate hydroquinone and how long do i use before i give it a break? my face and neck are so discolored from my body it looks very uncanny

[@CitySkinClinic]

Hi there, you will need to speak with your treating practitioner as Tretinoin and hydroquinone are prescription medicines and each person’s protocol has to be adapted to their skin type, needs, medical history etc. Each patients routine need to be personalised to get good results and avoid damaging the skin.

[@easy8figure]

@@CitySkinClinic hello doc i went to my dermatologist he said apply it twice per day for 3 months then to do a 3 month break, im scared it might irritate me so is it fine if i only use it at night for the first 2 weeks

[@aish_30]

I have post inflammatory hyperpigment in form of spot..have big spot on nose and forehead and in other areas it is small....when i apply it on spot, the area around my spot also brightens up,, so should i apply it on entire face?

[@CitySkinClinic]

Thanks Aish. I’m afraid I can’t provide specific medical advice as that would be irresponsible. I would however recommend reaching out to your medical provider since they should tell you what would be the best way to use it to treat your problems but also even out your skin tone and avoid patchiness. This will depend on a number of factors which they’ll evaluate based on your skin assessment. Good luck ❤️

[@LazyBunnyy]

I’ve used 4% for only a week and can see the skin darkening! Is this normal or should I stop using it?

[@CitySkinClinic]

Hey there, no this isn’t normal. You should stop using and urgently speak with your medical practitioner to find out what’s happened and how to rectify it!

[@youngmitlepcha9391]

Hello ma’am rebound pigmentation is only due to sun ?I got rebound pigmentation(melasma)should I again use hydroquinone because I don’t get result with other inhibitors and I have strict skincare but still no progress.

[@CitySkinClinic]

Hi, I;'m so sorry to hear that. So rebound hyperpigmentation can happen due to the sun but also if you use hydroquinone for a long period which can make the skin resistant to it or irritates the skin or destabilises the pigment making cells. All these can cause rebound hyperpigmentation. In this case, it may be best to take a break from hydroquinone and checkin with your practitioner. They can make sure its actually rebound hyperpigmentation and not something else. Based on that they can recommend whether to restart hydroquinone (and when) for a short course or to try another treatment. In general, they should also provide you with something to use after the hydroquinone to maintain your results.

[@profmj7630]

Are you wearing a sunscreen when you use hydroquinone? Maybe that would help you avoid the rebound effect. Or you could wear a hat or cover the area with longer shirts/pants.

[@youngmitlepcha9391]

@@profmj7630 yes I do use sunscreen daily

[@mamtaarora7174]

It is said it cause cancer is it true ?

[@CitySkinClinic]

Great question! So at the moment Hydroquinone is not classified as a carcinogen for humans based on the studies to date. However there are ongoing studies to assess whether it causes cancer. That being said there are other serious risks of using hydroquinone (especially in high concentrations and for prolonged periods). That’s why it is a prescription only medicine in the UK to ensure that it’s used safely and appropriately for short periods.