From the FDA Drug Label
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 treatment option for melasma (chloasma) is hydroquinone 4% skin bleaching cream. This cream is indicated for the gradual bleaching of hyperpigmented skin conditions, including melasma and chloasma 1.
- Key points:
- Hydroquinone 4% is used for skin bleaching
- Indicated for hyperpigmented skin conditions, including melasma and chloasma
From the Research
The most effective treatment for melasma is a combination of sun protection, topical medications, and sometimes procedures, with triple combination cream (hydroquinone, tretinoin, and fluocinolone acetonide) being the gold standard treatment. This approach is supported by the most recent and highest quality study available, which emphasizes the importance of a multimodality approach to treating melasma 2.
Key Treatment Components
- Strict sun protection with broad-spectrum SPF 30+ sunscreen applied every 2 hours when outdoors, along with wide-brimmed hats and sun-protective clothing
- First-line topical treatments include hydroquinone 4% cream applied once or twice daily for 8-12 weeks, often combined with tretinoin 0.025-0.1% and a mild corticosteroid in triple combination therapy
- Alternative treatments include azelaic acid 15-20%, kojic acid 1-4%, vitamin C serums, tranexamic acid (oral at 250mg twice daily or topical), and niacinamide 4-5%
Procedure-Based Treatments
- Chemical peels (glycolic acid, salicylic acid), microdermabrasion, or laser treatments may help in persistent cases, though these carry risks of worsening pigmentation if not done carefully
- Oral tranexamic acid has shown significant efficacy in treating melasma, especially in moderate and severe cases 3
Importance of Patient Education
- Melasma is a chronic condition that often recurs, especially with sun exposure, due to melanocyte overactivity triggered by hormones, UV radiation, and genetic factors
- Treatment requires patience as results typically take weeks to months to become noticeable, and patient education on sun protection and treatment adherence is crucial for successful management 2, 3