From the FDA Drug Label
HYDROQUINONE USP, 4% SKIN BLEACHING CREAM should be applied to affected areas and rubbed in well twice daily, in the morning and before bedtime, or as directed by a physician. If no improvement is seen after 2 months of treatment, use of this product should be discontinued. 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.
The guidelines for using hydroquinone cream are to apply it twice daily to affected areas, with treatment to be discontinued after 2 months if no improvement is seen. It is indicated for the treatment of hyperpigmented skin conditions such as chloasma, melasma, and freckles 1, 1.
- Key points:
- Apply twice daily
- Discontinue after 2 months if no improvement
- For hyperpigmented skin conditions
- Important consideration: Treatment should be limited to relatively small areas of the body at one time, as some patients may experience transient skin reddening and mild burning sensation 1.
From the Research
Hydroquinone cream should be used under medical supervision, typically in concentrations of 2-4% for treating hyperpigmentation conditions like melasma, post-inflammatory hyperpigmentation, and age spots, as supported by the most recent and highest quality study 2. When using hydroquinone cream, it is essential to apply a thin layer to affected areas once or twice daily, avoiding unaffected skin, and always use sunscreen (SPF 30+) during treatment as sun exposure can worsen pigmentation and reduce effectiveness. Some key points to consider when using hydroquinone cream include:
- Treatment duration should be limited to 3-4 months, followed by a break of equal length to prevent ochronosis (paradoxical darkening) 2.
- Discontinue use if irritation, redness, or burning occurs.
- Pregnant or breastfeeding women should avoid hydroquinone.
- The cream works by inhibiting tyrosinase, an enzyme involved in melanin production, thereby reducing pigment formation in skin cells.
- For enhanced results, hydroquinone is sometimes combined with retinoids and corticosteroids (triple combination therapy), but this requires specific medical guidance 3.
- After completing treatment, maintenance with non-hydroquinone lighteners like vitamin C, kojic acid, or azelaic acid can help preserve results. It is crucial to note that the use of hydroquinone cream should be carefully monitored, and patients should be reassured that with controlled use, hydroquinone can be well-tolerated and safe for a range of hyperpigmentary conditions 2.