Authors: Vanessa Ngan, Staff Writer, 2005; Updated: Dr Ian Coulson, Consultant Dermatologist, East Lancashire NHS Trust, Lancashire, UK. Copy edited by Gus Mitchell. September 2021. Show
What is hydroquinone?Hydroquinone is a skin-lightening agent used topically for the treatment of hyperpigmentation. Who uses hydroquinone?Hydroquinone is most commonly used in bleaching creams by patients aged 13 years and over with a dark skin type. It can be used, often in combination with other medications, to treat:
Hydroquinone may also be used as a pretreatment before fractional laser therapy or chemical peels. Skin conditions that may be treated with hydroquinoneWhat are the contraindications with hydroquinone?Hydroquinone should not be used by individuals allergic to hydroquinone or any of the excipients in the formulation such as the preservative metabisulphite. [see Contact allergy to preservatives] Tell me more about hydroquinone.Hydroquinone is used in a cream or lotion formulation in a concentration of 1-5%. It is often found in a combination formulation with other skin lightening agents such as topical retinoids (to increase efficiency) and low potency topical steroids (to reduce irritancy). In New Zealand and many other countries, hydroquinone is only available on prescription, and may need to be compounded by the pharmacist. Hydroquinone must be distinguished from monobenzyl ether of hydroquinone which can cause irreversible pigment loss. [see Depigmentation therapy for vitiligo] Mechanism of action of hydroquinoneHydroquinone lightens epidermal, but not dermal, pigmentation by reducing the production of new melanin:
How to use hydroquinoneHydroquinone is applied topically just to the hyperpigmented skin only, twice daily for 3 months, after which time many patients maintain their improvement by using it twice each week. If there has been no benefit after 3 months of treatment, then the hydroquinone should be stopped. Management of the underlying cause of the hyperpigmentation is also recommended. When initiating hydroquinone treatment, it is advisable to:
What are the benefits of hydroquinone?Hydroquinone is particularly effective for the treatment of postinflammatory hyperpigmentation which is unlikely to recur provided the underlying inflammatory dermatosis is also controlled. In melasma, 70% of sufferers notice clearance or reduction in pigmentation with twice daily hydroquinone used for three months. This improvement can be maintained in 50% of individuals with twice weekly application. Response of melasma after three months of hydroquinoneWhat are the disadvantages of hydroquinone?Hydroquinone does not treat pigmentation in the dermis. Melasma can be resistant to treatment and usually requires combination therapy and multiple therapeutic approaches, of which hydroquinone is one component. What are the side effects and risks of hydroquinone?Hydroquinone can cause mild irritant contact dermatitis when used in concentrations above 4%. A short drug holiday and/or application of a topical steroid will usually settle the reaction. Commercial formulations of hydroquinone contain the preservative metabisulphite, which can cause an allergic reaction. Concerns have been raised about the safety of hydroquinone in Europe, Japan, and the USA due to:
Other reported cutaneous adverse effects of hydroquinone include:
The safety of topical hydroquinone has not been established in pregnancy and lactation. Nail pigmentation due to hydroquinone use
How often should I use bleaching cream?Skin lightening creams are typically applied only to dark areas of skin once or twice a day. To use a skin lightening cream, it's advisable to follow the directions given by a doctor or on the packaging.
How long do you leave bleaching cream on?What happens if you leave bleach on your hair for too long? There's a misconception that bleach will work better the longer you leave it on. The maximum amount of time you should leave bleach on your hair is 30 minutes. Any longer than that and you run the risk of serious damage, including brittle strands.
How long does it take to see skin lightening results?You may want to take a few days off work until your skin's appearance starts to improve. It is common for skin to be red and swollen for a few days afterwards, and it may be bruised or crusty for 1 to 2 weeks. Over the next few weeks, your skin should start to fade to a lighter colour.
How long does it take for cream to start working?Moisturizer: Instantly, with Full Results After 2 Weeks
Everyone needs a moisturizer—yes, even if you have oily or acne-prone skin. And while you'll feel the results of a good moisturizer as soon as it absorbs, you'll begin seeing the results in your skin after using it consistently for one to two weeks.
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