From the Guidelines
PRP, in combination with hydroquinone 4%, is an effective treatment for hyperpigmentation, with a significant average decrease of 54% in Masi score and high patient satisfaction, as evidenced by a recent study published in 2025 1. When considering treatment options for hyperpigmentation, it's essential to prioritize morbidity, mortality, and quality of life. In this context, the use of PRP (platelet-rich plasma) as an adjuvant therapy or standalone treatment has shown promising results.
- The study published in Periodontology 2000 1 demonstrates the efficacy of PRP in improving skin quality and texture, with a notable reduction in hyperpigmentation.
- Hydroquinone 4% is a well-established treatment for hyperpigmentation, working by inhibiting tyrosinase, the enzyme responsible for melanin production.
- The combination of PRP and hydroquinone 4% may offer a synergistic effect, with PRP inducing collagen synthesis and improving skin texture, while hydroquinone 4% targets the underlying causes of hyperpigmentation.
- It's crucial to note that treatment outcomes may vary depending on individual skin types and conditions, and patients should consult with a dermatologist to determine the best course of treatment.
- As with any treatment, potential side effects and interactions should be carefully considered, and patients should be monitored closely to ensure optimal results and minimize adverse effects.
From the FDA Drug Label
Topical application of hydroquinone produces a reversible depigmentation of the skin by inhibition of the enzymatic oxidation of tyrosine to 3,4-dihydroxyphenylalanine (dopa) HYDROQUINONE USP, 4% SKIN BLEACHING CREAM is indicated for the gradual bleaching of hyperpigmented skin conditions such as chloasma, melasma, freckles, senile lentigines, and other unwanted areas of melanin hyperpigmentation.
Hydroquinone 4% can help with hyperpigmentation by gradually bleaching the affected areas. The mechanism of action involves inhibition of the enzymatic oxidation of tyrosine, leading to reversible depigmentation of the skin 2.
- Key benefits: gradual bleaching of hyperpigmented skin conditions
- Target conditions: chloasma, melasma, freckles, senile lentigines, and other unwanted areas of melanin hyperpigmentation 2
From the Research
Hyperpigmentation Treatment
- Hyperpigmentation, including melasma and post-inflammatory hyperpigmentation (PIH), can be challenging to treat, but various options are available, including topical lightening agents, chemical peels, and laser-based therapies 3.
- Hydroquinone 4% is a commonly prescribed and researched topical lightening agent, and it is US FDA-approved for the treatment of hyperpigmented skin 3.
PRP and Hydroquinone for Hyperpigmentation
- A study found that the combination of autologous platelet-rich plasma (PRP) and hydroquinone 4% is more effective than hydroquinone alone in the treatment of melasma, with a significant improvement in the modified Melasma Area and Severity Index (MASI) score 4.
- The combination of PRP and hydroquinone 4% showed greater improvement than hydroquinone alone, with a mean percentage improvement in modified MASI score of 82% compared to 69% for hydroquinone alone 4.
Efficacy of Hydroquinone
- Hydroquinone monotherapy and triple combination cream (hydroquinone, tretinoin, and corticosteroid) are considered the most effective and well-studied treatments for melasma 5.
- Hydroquinone 4% is a safe and effective treatment for hyperpigmentation, but it can cause adverse effects such as skin irritation, dryness, and post-inflammatory hyperpigmentation 5.
Alternative Treatments
- Other treatments for hyperpigmentation, including chemical peels, laser- and light-based devices, and oral agents, have mixed results and may be associated with a higher risk of adverse effects 5.
- Retinoids and azelaic acid have been shown to be effective in treating acne and post-inflammatory hyperpigmentation in skin of color, and they are considered safe and beneficial in this patient population 6, 7.