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.
- Hydroquinone is a topical cream that can be prescribed for melasma.
- The specific formulation is hydroquinone 4% skin bleaching cream 1.
- It is used for the gradual bleaching of hyperpigmented skin conditions, including melasma.
From the Research
The most effective topical cream for melasma is a triple combination cream containing hydroquinone, tretinoin, and a corticosteroid, as it has been shown to be reasonably safe and effective in treating melasma, especially in patients with darker skin types 2. When prescribing a topical cream for melasma, it is essential to consider the patient's skin type and the potential side effects of the treatment.
- Hydroquinone 4% is considered the gold standard treatment for melasma, but it can cause skin irritation, redness, and other side effects.
- Triple combination creams, such as those containing hydroquinone, tretinoin, and fluocinolone, have been shown to be more effective than single agents in treating melasma, with significant improvements in melasma area and severity index (mMASI) scores and skin lightness 3.
- Alternative prescription options include azelaic acid 15-20%, tretinoin 0.025-0.1%, or tranexamic acid formulations, which work by inhibiting melanin production or increasing cell turnover.
- Strict sun protection is essential while using these treatments, with broad-spectrum SPF 30+ sunscreen applied daily and reapplied every 2 hours when outdoors.
- Treatment should be supervised by a dermatologist, as these medications can cause irritation, redness, or other side effects, and results typically appear after 8-12 weeks of consistent use, with maintenance therapy may be needed as melasma often recurs 2.