Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 10/16/2020
Dealing with melasma can be a challenging experience. From small areas of discoloration to large, obvious skin hyperpigmentation, melasma can range from an annoyance to a worrying skin condition that affects your confidence and self-esteem.
Although melasma isn’t dangerous to your physical health, it can have serious effects on your emotional well-being. Several studies even show that melasma can even affect your social life, preventing you from having the confidence to form relationships and enjoy life to its fullest.
We’ve covered the causes, symptoms and effects of melasma in more detail in our complete guide to melasma.
There are numerous treatments available for melasma, ranging from topical creams to chemical peeling and microdermabrasion. Below, we’ve covered everything you need to know about one of the most popular melasma treatments on the market—hydroquinone.
Hydroquinone is an organic compound that’s used to treat a variety of discoloration-related skin conditions. It’s a skin lightening agent that works by reducing your production of melanin. When used topically, hydroquinone can cause your skin to lighten in color.
Hydroquinone is widely used as a scar treatment. Applied topically, it can cause darkened scars to lose some or all of their extra pigmentation, causing them to blend in and match the color of the surrounding skin.
It’s also used as a treatment for skin hyperpigmentation caused by UV exposure (spending too much time in the sun) and inflammation.
Topical hydroquinone creams are available as prescription medication to treat melasma and other pigmentation-related skin conditions. You can also buy limited strength hydroquinone as an over-the-counter medicine in most pharmacies.
Hydroquinone is one of the most effective topical treatments on the market for melasma. It has been thoroughly tested in numerous studies, almost all of which show that it works effectively to reduce pigmentation and even out the blotchy, darkened patches of skin that melasma causes.
In one 2007 study, application of a cream containing hydroquinone and retinol as part of a combination therapy led to “sustained improvements” in skin coloration in people with melasma.
Hydroquinone also performed well in a 2013 study, producing a measurable reduction in MASI scoring (Melasma Area and Severity Index, a scoring system used to assess melasma) over a period of 12 weeks.
In the same study, hydroquinone also produced better results than kojic acid cream—a popular over-the-counter treatment for melasma and skin hyperpigmentation.
In short, hydroquinone is scientifically proven to reduce the amount of skin discoloration caused by melasma. For most people, it produces a noticeable improvement after eight to 12 weeks of consistent use, although some people might see improvements in their skin sooner. If there is no improvement after two months to three months, you should discontinue and follow up with your healthcare provider.
However, this doesn’t mean that hydroquinone is guaranteed to treat melasma completely on its own. For more severe cases of melasma, hydroquinone is often combined with a topical retinoid such as tretinoin.
For persistent melasma, it’s often used in combination with a retinoid and a corticosteroid. This obviously increases the risk of side effects occurring, as many corticosteroids can produce side effects when used over the long term.
If you’ve been prescribed hydroquinone, the best approach is to follow the instructions provided by your healthcare provider.
Applying hydroquinone is simple. It’s best to test yourself for sensitivity before you begin using hydroquinone regularly. To test your skin, apply a small amount of hydroquinone cream to your melasma-affected skin, then check for itchiness or redness over the next 24 hours.
If you don’t experience any itching, soreness or redness, you can start treatment by following the instructions below:
Before applying hydroquinone, clean the hyperpigmented skin. Make sure the skin is completely dry before applying any hydroquinone cream.
Apply a small amount of hydroquinone cream to the melasma-affected skin. It’s best to use just enough cream to cover the hyperpigmented area. Take care not to apply any hydroquinone cream to non-melasma skin, as it can potentially lighten its color.
Wash your hands thoroughly after applying the hydroquinone cream. Wait for the cream to fully dry before applying makeup, moisturizer, sunscreen or any other topical products.
Take care when applying hydroquinone cream near the eyes, nostrils and mouth. If your melasma-affected skin is close to these areas, consider using a cotton swab to apply the cream more precisely.
Avoid using other lightening products on skin you’re treating with hydroquinone, as it’s possible for combinations of lightening agents to cause redness and irritation. If you’ve applied too much hydroquinone, wash the excess away using soap and water.
Do not use hydroquinone if you are pregnant or breastfeeding. Right now, there simply isn’t enough scientific evidence to show that hydroquinone is completely safe to use in pregnancy — it currently carries a Category C rating from the Food and Drug Administration (FDA).
On average, it takes four to eight weeks for hydroquinone to produce noticeable skin lightening results, meaning you’ll need to apply it consistently before your melasma-affected skin begins to lighten and match the rest of your face.
Hydroquinone has been in use for decades, with a good safety record and relatively few safety issues. However, like most other skin medications, excessive or improper use of hydroquinone can and often does cause side effects.
The most common side effects of hydroquinone are itchiness, redness, stinging and other forms of skin irritation. These are typically mild and temporary. Some hydroquinone users notice mild, non-permanent irritation after applying the cream to their skin for the first time.
If you’re sensitive to hydroquinone, it’s also possible for the medication to cause a more severe form of allergic contact dermatitis, which could potentially involve more significant skin burning, itching and crusting. In some cases, hydroquinone can cause minor swelling.
If you experience these side effects, it’s best to seek medical advice and cease further use of hydroquinone cream.
Finally, hydroquinone use is linked to the development of ochronosis. This is extremely rare, with most cases occurring in Africa. Current research indicates that this might be caused by exposure to hydroquinone in combination with antimalarials and other substances.
In general, hydroquinone is a safe, effective medication that’s been successfully used to treat melasma and other skin conditions for decades.
Studies show that hydroquinone works well as a treatment for melasma, helping to reduce skin discoloration and make blotchy, uneven patches of skin more consistent. However, it’s far from the only treatment available for melasma and other pigmentation-related skin conditions.
Looking for more skincare tips from the hers pros? Head on over to the blog.