Is hydroquinone safe for melasma?

Part of: Melasma & pigmentation

Hydroquinone is an established option for melasma when used as a defined course of about 3 months under medical follow-up. The serious risks, such as irritation and a rare blue-grey darkening that is hard to treat, are linked to long, unsupervised use or high strengths. It should not be used as an open-ended lightening cream.

How long is it used?

  • A defined course of about 3 months, a thin layer on the dark patches only, as prescribed.
  • Start with a test on a small area (about 1 cm) for 24 hours; if there is no redness or irritation, widen the use.
  • If there is no benefit after 3 months, stop it and reassess the diagnosis and the plan.
  • After improvement, the doctor decides whether maintenance at a lower frequency is needed.

What to avoid

  • Open-ended use for months or years without follow-up.
  • High strengths, and creams of unknown composition or source.
  • Applying it to healthy skin; it goes on the dark patches only.
  • Carrying on through clear irritation; reduce or stop it and see a doctor.
  • Sun without protection; sunscreen is essential during and after treatment.

When to see a doctor

  • Before starting, to confirm the patches really are melasma.
  • No improvement after 3 months.
  • Severe burning, redness or scaling, or a rash or any sign of allergy.
  • Grey-blue patches appearing where it was used.
  • Pregnancy or breastfeeding: its safety has not been established, so ask a doctor first.

Pigmentation and Melasma: How to Treat Them Without Making Them Worse

Medical references

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