Hydroquinone is the most prescribed product to treat skin discoloration caused by hormonal imbalance, sun damage, acne scars and other marks left by skin trauma.1
It's available over the counter (OTC) in strengths up to 2%. Hydroquinone (HQ) 4% or higher requires a prescription.
Hydroquinone is legal, considered safe for topical use in humans1 and has not been banned by the FDA.1
However, despite close to 40 years of a safe and successful history in the US, controversy lurks in its shadows. An overgeneralization that hydroquinone is dangerous has kept its effectiveness from people who could benefit from its proven ability to lighten hyperpigmentation and return skin's natural clarity.
Don't miss out. Get the facts and find out if HQ could help you.
Hydroquinone is an organic compound that is widely used as a skin lightener. It was approved by the FDA in 1982.
No, hydroquinone is not banned in the US. It is legal but regulated. Hydroquinone concentrations of 4% or more require a prescription.
In 2006, the FDA proposed a ban on most hydroquinone products but did NOT enact the ban. In the chapter, Lifetime Skincare, written by Dr. Susan Obagi and published in the book Cosmetic Facial Surgery, Dr. Obagi points out that the proposed ban was based on study data from oral ingestion of hydroquinone in lab animals, misuse or overuse in dark skin types, or harm caused by hydroquinone products mixed with mercury or other toxic and/or illegal products.2
Hydroquinone 4 (HQ4) refers to the 4% concentration of the active ingredient, hydroquinone. It is the highest "potency" or concentration of hydroquinone permitted in the US by pharmaceutical manufacturers. Stronger concentrations can be custom-made for you by a compounding pharmacy. Hydroquinone 4% and higher are prescription-only.
Hydroquinone is prescribed to treat skin darkening caused by
- Melasma, also called pregnancy mask
- Acne scars
- Post-traumatic inflammatory response (marks left after skin trauma heals)
- Sun damage
- Uneven skin tone
- Liver spots, solar lentigines, age spots
- Redness caused by psoriasis and eczema
Dark spots are caused by the overproduction of melanocytes, the cells responsible for creating melanin. Hyperpigmentation can occur if the immune system responds to an injury by producing excessive skin cells and the initial inflammatory response to an injury does not go away.
Hyperpigmentation can appear as brown/gray patches in the case of melasma; small "dots," called freckles; or large spots, called sun spots. Darker patches visible on hands and the face may be called liver or age spots.
Scars are also a type of overpigmentation. Scars are usually reddish brown. This type of hyperpigmentation, especially from acne scars, can be deep within the skin and stubborn.Tretinoin is the #1 prescribed treatment for acne and can help renew skin damaged by scars and may be combined with hydroquinone to erase hyperpigmentation. Vitamin C is a proven brightener and antioxidant. Learn more about the benefits of combination therapy with HQ, Tretinoin and Vitamin C.
Hydroquinone works by slowing or normalizing the production of melanin and stopping the production of melanocytes. It also causes exfoliation, so that new, lighter skin replaces the outer darker layer of the epidermis. In pharmacological terms, hydroquinone inhibits the production of tyrosinase and suppression of other melanocyte metabolic processes.
Results may be seen in 4 weeks, but they vary for each individual.
You can continue to use hydroquinone as recommended by your doctor without taking a break unless your physician or pharmacist advises you to do so. Concerned about hydroquinone? Read this.
When using hydroquinone, it is important to use sunscreen. Hydroquinone will make your skin sensitive to the sun. As well, sun exposure without sunblock is a main cause of dark spots. Besides damaging your skin, sun exposure would undo the skin bleaching you have achieved with hydroquinone.
Cleanse and dry your skin. A toner may be applied before using it to enhance the absorption and effectiveness. Only a small portion is needed, a pea size amount may work. Apply to the entire affected area. Do not spot treat. If using hydroquinone on your face, avoid the eye area. Be sure to wash your hands after use. Always wear sun protection if you will be exposed to sun.
Yes, you can. A common recommendation is to apply Vitamin C serum in the morning with hydroquinone, followed by moisturizer, then strong sun protection. If you experience redness or irritation, you may try applying the Vitamin C serum in the morning and hydroquinone at midday. Apply the tretinoin at night. Obagi Nu-Derm Sunfader combines Vitamin C and hydroquinone with sunscreen for a one-step morning routine. Just apply the tretinoin at night. Another option is to purchase the complete Obagi-C Rx System for normal to dry skin or normal to oily skin with a Vitamin C cleanser, Vitamin C am and pm toner, a hydroquinone + Vitamin C serum, a broad spectrum sunblock and a Vitamin C night cream!The 5-step system provides a guide so you can stay on top of your skin care routine for your brightest and clearest complexion.
Melasma may be caused by hormonal imbalance during menopause,1 photoaging (long-term exposure to the sun), side effects from certain medications,1 oral contraceptives containing hormones or medications containing hormones.1 It is most common in women1 and some studies show it may be hereditary.1
Due to the sudden change in women's hormones during pregnancy, melasma frequently develops at that time. For this reason, you melasma has earned the nickname "pregnancy mask."
Men and women with the hyperactive thyroid condition Graves' Disease 3 may also develop hyperpigmentation, a common side effect of thyroid hormone imbalance.
Melasma is most commonly associated with darkening of skin above the lip and on cheekbones. It can also appear as asymmetrical gray and brown spots on high areas of the face, such as cheeks, forehead, nose and other body areas prone to frequent sun exposure.
Yes, men can develop hyperpigmentation but they are less prone to it than women. Usually hyperpigmentation in men is visible on the arms and shoulders, resulting from a combination of hormone imbalance and photoaging. 4
Yes, the names are often used interchangeably. The medical term for liver spots is solar lentigines. They are brown patches or extra-large freckles that develop from long-term exposure to the sun.
Learn more about HQ4, check out our blogs: How To Use FDA-Approved Hydroquinone For The Best Skin Bleaching and A Real Story On Hydroquinone: Lisa's Transformation.
1 Schwartz C, Jan A, Zito PM. Hydroquinone. [Updated 2020 Feb 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539693/
2 Cosmetic Facial Surgery. 2nd ed. Elsevier; 2018:656-667.
3 Song X, Shen Y, Zhou Y, et al. General hyperpigmentation induced by Grave's disease: A case report. Medicine (Baltimore). 2018;97(49):e13279. doi:10.1097/MD.0000000000013279
4 Sarkar R, Ailawadi P, Garg S. Melasma in Men: A Review of Clinical, Etiological, and Management Issues. J Clin Aesthet Dermatol. 2018;11(2):53-59.