What Is It Like to Use Hydroquinone Skin-Bleaching Cream for Dark Spots?
Key takeaways:
Hydroquinone is a prescription skin-lightening treatment for dark spots and discoloration.
In the U.S., only prescription hydroquinone products are approved for safe use.
Three people share their experiences using hydroquinone cream for melasma, hyperpigmentation, and sunspots.
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Hydroquinone is a skin-lightening agent. The prescription medication is used to treat skin discoloration, such as melasma, freckles, and hyperpigmentation. Hydroquinone is available as creams, gels, and solutions — but only with a prescription in the U.S.
FDA warning
The FDA warns consumers against unapproved over-the-counter (OTC) skin-lightening products containing hydroquinone. These OTC products, which can cause severe side effects like skin rashes and permanent discoloration, are illegal in the U.S. Only the prescription product Tri-Luma is FDA approved for use. Consumers are urged to consult with healthcare providers for safe treatment options and to avoid products containing hydroquinone or mercury.
Dark spots covered her face
Shanna Bynes Bradford, 48, started using hydroquinone cream 10 years ago. She wanted to treat dark spots on her face caused by sun exposure.
“They covered my whole face,” says Shanna, a licensed medical aesthetician in Weston, Florida.
Shanna had tried OTC hydroquinone creams with little improvement. So she asked her dermatologist to prescribe a 4% hydroquinone cream. Shanna’s dermatologist told her to apply the hydroquinone cream to the dark spots on her face using a cotton swab.
“I was to use it only at night,” Shanna says. “During the day, I had to put on facial moisturizer and sunscreen.”
After 2 weeks, Shanna noticed her dark spots and hyperpigmentation lightening. Her dermatologist advised her to use hydroquinone for no more than 3 months, followed by a 3-month break. But Shanna loved her skin’s appearance so much that she used it longer than advised, leading to pink patches and increased sun sensitivity on her face.
“I went overboard,” she says.
Today, Shanna uses 4% prescription hydroquinone sparingly as a spot treatment. She encourages others to consult a dermatologist for guidance.
“They should give you a protocol about how to use the cream and a postcare treatment form,” Shanna says. “Follow the instructions, and make sure you keep your follow-up appointment.”
What’s the difference between hydroquinone and tretinoin? Here’s a comparison of the medications and their uses.
What does hyperpigmentation look like on darker skin tones? Areas of darker skin can also happen to people with darker skin tones. Here’s what it can look like.
Is melasma worse for people of color? Melasma is a type of hyperpigmentation that causes brown discoloration on the face. It mostly affects women of color.
She was self-conscious about her upper lip
Hannah Kopelman, MD, a 33-year-old dermatologist in Englewood, New Jersey, used hydroquinone cream to treat brown patches (melasma) on her upper lip and cheeks. Her melasma was difficult to cover with makeup.
“I remember feeling especially self-conscious during outdoor events when sunlight would exacerbate the pigmentation, making it darker,” Hannah says. At one family gathering, Hannah worried that people were staring at the uneven patches on her face. So she was hesitant to engage in conversations and struggled to enjoy the event.
“The melasma looked like hair,” Hannah says. “It was something that I wanted to go away, and [I wanted to] get the area to look like normal skin.”
Hannah applied a thin layer of 12% hydroquinone cream to the affected areas a few nights a week for 12 weeks. To prevent further sun damage, she wore SPF 50+ broad-spectrum sunscreen daily.
Today, Hannah uses hydroquinone cream for spot treatments only. She’s vigilant about wearing sunscreen. She uses sunscreen with the physical blocker zinc oxide and chemical blockers such as avobenzone, octocrylene, homosalate, and octinoxate for added protection. Hannah wears a wide-brimmed hat when she’s outside for extended periods. She tries to stay out of the sun as much as possible during the day.
Hannah says hydroquinone lightened her melasma to her satisfaction.
“I wouldn’t say it’s 100% gone, but it’s improved and it’s much lighter,” she says.
Her postprocedure brown spots disappeared
May Hall, DO, a 35-year-old dermatologist near Asheville, North Carolina, used hydroquinone to treat hyperpigmentation on her face and neck after a microneedling procedure. Brown patches appeared on her face after the treatment, she says.
May often got hyperpigmentation on her skin after skin-treatment procedures because of her olive complexion. Even a blemish could leave a dark mark on her face. May attributes the hyperpigmentation on her neck to sun exposure after the procedure.
“I was not as vigilant about sun protection around my neck,” May says. “The spots looked blotchy, and I was eager to try to resolve the hyperpigmentation.”
She applied a pea-size amount of 8% hydroquinone cream to her face every night for about a month.
“My skin cleared up in about a month,” she says. She didn’t expect to see results for several weeks. “I was very happy with the results, and they were pretty fast,” she says.
She discontinued the cream when her skin returned to its normal tone. She now takes extra care with sunscreen to prevent further pigmentation.
“My skin responded very well to it,” May says. “I would have no problem going through another cycle of hydroquinone if I needed to in the future.”
What does the doctor say?
Patricia Pinto-Garcia, MD, MPH
Senior Medical Editor
Prescription hydroquinone products can help lighten darker patches of skin caused by melasma and postinflammatory hyperpigmentation.
These products are very powerful, but it’s important to use them as directed. Hydroquinone works by lowering the production of melanin, the chemical that creates skin pigment.
Hydroquinone also damages melanocytes, the cells that make melanin. Damage to melanocytes can be long lasting and even permanent. So overuse of hydroquinone can make your dark patches lighter than your natural skin tone. Less melanin also increases your skin’s sensitivity to sunlight’s UV rays. So it’s important to wear sunscreen every day while using hydroquinone therapy.
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