Hydroquinone 4% topical lotion/cream is considered as the gold standard treatment method for Melasma. Because of its depigmentation ability by reducing melanin production in the skin. Therefore hydroquinone 4 is prescribed widely in the world by dermatologists for melasma. It is proven from patient’s studies also that long term use of the cream gives better results.
Melasma is a skin condition that skin gets hyperpigmented as irregular, geographical areas. It is mainly detected in sun-exposed areas of the face like the forehead, cheeks, upper lips, and chin. Studies show that the majority of the affected people have darker skins like skin type IV-VI. And most Asian countries have reported a larger amount of cases with melasma. There is a clear gender variation in which females have nine times more chances of getting this condition. Pregnancy is one of the main stages that women get these.
There are several factors that can cause melasma. Ultraviolet radiation, darker skin, excess estrogen hormone, anti-epileptic drugs, and genetics are the identified causes. UV radiation is the main cause. UV light can stimulate Melanocyte Stimulating Hormone ( MSH ) and Adrenocorticotropic hormone ( ACTH ) which can increase fibroblasts and tyrosine kinase production. At the same time it increases the formation of Vascular Endothelial Growth Factors ( VEGFs ) which ultimately causing increase melanocyte production in the skin.
Its found that pregnancy and taking oral contraceptives can increase the estrogen receptors in the body which also a cause for melasma. Studies have found that increased estrogen receptors in melasma lesions.
Melanocytes are responsible for giving the darker skin. Therefore excess melanocytes form irregular hyperpigmented patches in the face.
Although this condition is not fatal or the lesions are not cancerous it can cause serious damage to the quality of the life of a person. There are lots of females that suffer from this condition who could not able to go outside. They can’t wear clothes they like, they are unable to attend gatherings that they previously participated in. So studies showed that melasma causes serious psychological and social issues in society.
Because there is a clear female predominance of the prevalence these psychosocial issues have a serious weight compared to other diseases. What is use for hydroquinone 4% cream – the answer is simple – drive back the confidence of the suffering patients.
Hydroquinone is an oxidizing agent which composed of dihydroxybenzene. This compound is structurally similar to precursors of melanin. It inhibits the enzyme tyrosinase. Thereby convention of L 3,4- dihydroxyphenylalanine ( L – DOPA ) to melanin mechanism stops. So melanin production is reduced. Hydroquinone also can damage the cell membranes of the melanocytes and other membranous structures also. These damaged melanocytes eventually die without causing serious damage to the skin.
Hydroquinone 4% is one of the commonest forms available in the market as a treatment for melasma. Studies showed that the regular application of hydroquinone 4% can give better results. There can be seen depigmentation by 5 – 7 weeks of application. And the regular application for three months to one year evident best results from the cream. It is recommended that using sunscreen and topical steroids at the same time gives better results.
In other words – how long do the effects of hydroquinone 4 cream work? The application of cream should be a thin layer over the pigmented areas. You can use the cream 1 – 2 times per day for 3 – 6 months and discontinue for a few weeks to avoid side effects. Or you can apply it only on weekends or three days a week for up to a period of one year. This allows more extended application time and fewer side effects compared with daily use.
Using sunscreen at the same time can protect your skin from UV light. Therefore occurring of further pigmentation is avoided.
• If you have known allergic reactions or hypersensitivity for hydroquinone.
• If you daily exposed to the sun for a long period of time.
• If there are conditions or using drugs that cause photosensitivity.
All the above conditions should be excluded before using hydroquinone 4% cream.
The drug doesn’t show any malformations or adverse reactions to pregnancy. The systemic absorption of hydroquinone 4% is about 30 – 40%. But it’s better to use in small doses in pregnancy. Breastfeeding has no clear evidence to suggest that the drug is harmful to the mother or the child. So better avoid breastfeeding period.
0.75% of Kojic acid is one of the skin lightening drugs in the market. People have doubts that what is best for melasma. There was a comparative study to detect the effectiveness between hydroquinone 4% and kojic acid creams. It shows that both topical agents can give better results for melasma. Because both agents act on inhibition of tyrosinase enzyme.
But hydroquinone cream has an additional advantage as it can damage the melanocytes and degrade them easily. Thereby studies show that the melasma improvement rate from hydroquinone cream is 40 – 75% faster than kojic acid.
And both of them have a significantly low side effect profile makes hydroquinone 4% a better option for melasma.
Hydroquinone 4% is available online as an over the counter medication or a prescription variant. And also now you can order it online as well via the OKDERMO Skincare store. You may ask “how much is hydroquinone 4 cream ?” – Press the link and you will see the actual prices.
1. Topical treatment of Melasma by Debabrata Bandyopadhyay ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2807702/#!po=20.3125 )
2. Hydroquinone by Schwartz C, Jan A, Zito PM ( https://www.ncbi.nlm.nih.gov/books/NBK539693/ )
3. A Comparative Study of the Efficacy of 4% Hydroquinone vs 0.75% Kojic Acid Cream in the Treatment of Facial Melasma by Rochelle C Monteiro, B Nanda Kishore, […], and H Kamath Ganesh ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657227/ )