Topical skin-lightening cream for hyperpigmentation such as melasma and age spots.
Reviewed by:
Dr. Steve Malen, PharmD
Dr. Steven Blikstein, PharmD
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Hydroquinone 4% cream is a prescription depigmenting agent used to gradually lighten areas of hyperpigmentation, including melasma, chloasma, freckles, and age (liver) spots. It works by inhibiting melanin production in the skin. Apply a thin layer to the affected area twice daily (morning and bedtime) and rub in well; daily broad-spectrum sunscreen (SPF 15 or higher) is essential to prevent repigmentation. If no improvement is seen after 2 months, discontinue use and consult your provider. Common effects are mild dryness, stinging, or redness at the application site. Prolonged, high-dose use has rarely been linked to exogenous ochronosis (a blue-black skin discoloration). For external use only — avoid the eyes and mucous membranes. Not established as safe in pregnancy or in children under 12.
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Sunscreen (broad-spectrum SPF 15+) is required with daily use — sun exposure can worsen the pigmentation being treated and increase irritation.
Rarely, prolonged or high-strength use can cause exogenous ochronosis, a gradual blue-black darkening of the skin; stop use and contact your provider if this occurs. A small test patch is recommended before first use to check for sensitivity.
Common effects: mild dryness, stinging, redness, or fissuring at the application site. Avoid the eyes and mucous membranes. Safety in pregnancy and in children under 12 has not been established.