Hydroquinone cream melasma guide
How to patch-test, apply and review prescribed hydroquinone 4% cream, with strict sun protection and duration limits.
Hydroquinone cream melasma guide
How to patch-test, apply and review prescribed hydroquinone 4% cream, with strict sun protection and duration limits.
- READ TIME
- 3 min read
- PATHWAY
- Hydroquinone 4% cream
- DOSE RANGE
- Patch test, 24 h → Stop, planned break
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How to use
- What it is and how it works
HQUIN cream contains hydroquinone 40 mg/g. It reduces formation of new melanin and is used on small areas of confirmed melasma; it does not diagnose or treat a changing pigmented lesion.
- Apply it as prescribed
Before the first facial use, patch-test a small amount on the inner forearm for at least 24 hours and do not continue if it irritates. Apply a thin layer only to small, intact pigmented patches once daily for 10–15 days, then twice daily if tolerated. Avoid the eyes, lips and mucosa and wash your hands afterwards.
- Skin care and interactions
Use broad-spectrum SPF 50+ every day, reapply every 2–3 hours during exposure and use physical shade; avoid UVA. Do not apply hydrogen peroxide or benzoyl peroxide to the same area, do not cover it with an occlusive dressing and do not add another hydroquinone product. This is the HQUIN cream vehicle; do not substitute the Licoforte gel without checking excipients and tolerance.
First 2 months. Take dated photographs in the same daylight at the start, 4 weeks and 8 weeks; fading is too gradual to judge by memory. Apply only to the patches and wash your hands; a halo of lighter skin means the cream is spreading. Broad-spectrum SPF 50+ every morning, reapplied every 2 to 3 hours outdoors, plus a hat; UVA and visible light both drive melasma.
Ongoing. Stop and ask for review if the skin darkens, develops blue-black marks, stays irritated, or if the product itself turns dark. Tell your doctor if you become pregnant or start hormonal contraception; both affect melasma and the treatment plan. After the course, keep SPF daily; pigment returns without it. Your doctor plans any repeat course after a break.
Treatment pathway
- Patch test, 24 hDay 0
- 4%Days 1-15
- 4%Weeks 3-12
- Stop, planned breakDay 90
Reviews happen through your account chat; send dated photos in the same daylight each time.
See the full decision pathway
Your hydroquinone pathway
Days 1-90
Hydroquinone 4% on the patches
Once daily for 10 to 15 days, then twice daily if tolerated, with SPF 50+ every day.
At 2 months, are the patches visibly lighter on like-for-like photos?
Yes
Complete to day 90, then break
Finish the course, stop, and maintain with sun protection. A repeat course is planned only after a break.
No
Stop and review
The SmPC advises stopping if there is no improvement at 2 months. Your doctor may switch to the gel or the compounded formula, or reassess the diagnosis.
Days 1-90After the course
Maintained
SPF only
Daily broad-spectrum protection keeps the result; review if pigment returns.
Recurrence
Repeat after a break
A further 60 to 90-day course, never exceeding 6 months of continuous use, or a step up to the compounded formula.
Reviews happen through your account chat; send dated photos in the same daylight each time.
Dose schedule
| Dose | When | Note |
|---|---|---|
| Patch test, 24 h | Day 0 | Inner forearm; do not start if it irritates. |
| 4% once daily | Days 1-15 | Patches only; SPF 50+ every day. |
| 4% twice daily | Weeks 3-12 | If tolerated. Photo review at 2 months; stop if no improvement. |
| Stop, planned break | Day 90 | Never more than 6 months continuously; SPF continues. |
How it compares
| Melasma treatments compared | How it works | Best suited for | How often | Course | Product type |
|---|---|---|---|---|---|
| Hydroquinone 4% cream | Tyrosinase inhibitor; slows new pigment formation | First course; defined patches; drier or sensitive skin | Once daily, then twice daily | 60-90 days | EU-authorised medicine |
| Hydroquinone 4% gel | Same active in an alcohol-glycolic acid base for better penetration | Resistant patches; oilier skin; tolerates a drier vehicle | Once daily, then twice daily | 60-90 days | EU-authorised medicine |
| Compounded melasma formula | Hydroquinone plus tretinoin, kojic acid and niacinamide (Kligman principle) | Patches that have not responded to hydroquinone alone; no pregnancy plans | Two nights a week | 3 months | Pharmacy-compounded to prescription |
All three require daily broad-spectrum SPF 50+ and a planned break after the course. Hydroquinone is not recommended in pregnancy; tretinoin is contraindicated.
Side effects
Local irritation
Mild redness, dryness, stinging or peeling can occur, especially at the start. Use a gentle moisturiser and follow the prescribed adjustment plan. Stop and seek advice if the reaction is marked or persistent.
Darkening or blue-black marks
Stop and request assessment if the skin becomes persistently darker or develops blue-black marks. Prolonged hydroquinone use can cause ochronosis. Do not use a cream or gel that has turned dark or blackish.
Do not use if
- You are allergic to hydroquinone or an ingredient in the dispensed product
- The area has ochronosis, open wounds, eczema, marked irritation or sunburn
- You are pregnant, trying to conceive or breastfeeding
When to contact your doctor
- Facial swelling, breathing difficulty, widespread blistering, eye pain, light sensitivity or altered vision: seek urgent medical care
- Persistent irritation, worsening pigmentation, blue-black marks or a product that has turned dark
- There is no improvement after 2 months, or the diagnosis or treatment area is uncertain
Storage
Keep the tube tightly closed, protected from light and below 25°C, out of children's reach. Do not use it after expiry or if the cream becomes dark or blackish.
What to expect
Hydroquinone affects newly produced pigment, so fading is gradual and temporary. Daily photoprotection is part of treatment and helps reduce recurrence. Compare dated photographs in the same lighting at the 2-month review.
Sources
Questions while you're on treatment?
Message your doctor in your private chat about side effects, doses or anything that worries you. Replies in under 2 hours on average.
- Follow up on your skin treatment in the chat
- Download your e-prescription
- Renewals reviewed by your doctor
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