Hydroquinone
Unchecked
Hydroquinone
Lustra, EpiQuin Micro, Melquin, Tri-Luma (with tretinoin and fluocinolone)
Experience
No personal reports yet
No clinical reports yet
Log in to add your own experience.
Problems
No problems yet. Be the first to suggest one.
+ Add a problemTitration strategies
No titration strategies yet. Be the first to suggest one.
Effects
No effects listed yet. Be the first to suggest one.
Relevant anecdote
No anecdotes yet. Share a relevant one.
Relevant Literature
No literature entries yet.
Log in to submit relevant literature.
Summary
Common uses
Melasma0, Post-inflammatory hyperpigmentation0, Ephelides/lentigines (selected)0
Pharmacy
Starting dose
Apply thin layer to hyperpigmented areas BID; limit to 4-6 month courses to avoid ochronosis
Preparations
4% prescription cream/lotion; OTC 2% withdrawn in US (2020 CARES Act); compounded higher strengths available
US FDA Max
4% topical; limit duration of use
Pharmacology
Routes
Topical
Onset
Visible lightening at 4-12 weeks
Duration
Hours per application
Half-life
Not meaningfully described — topical local action with minimal systemic absorption[1]
Bioavailability
Topical with limited but measurable systemic absorption[1]
Pregnancy
Generally avoided in pregnancy.[citation needed]
Legal status
Rx-only in US since 2020 (OTC 2% formulations withdrawn under CARES Act due to safety concerns)
Purported mechanism
Hydroquinone inhibits tyrosinase, the rate-limiting enzyme converting tyrosine to melanin in melanocytes; reduced melanin synthesis lightens hyperpigmented skin over weeks.0 Exogenous ochronosis (paradoxical blue-black hyperpigmentation, irreversible) is the most-feared adverse effect of prolonged use and the basis for the typical 4-month course limit. Combination with tretinoin and a low-potency steroid (Kligman formula, marketed as Tri-Luma) is more effective than monotherapy for melasma[1].
References
[edit | edit source]- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Tri-Luma (fluocinolone, hydroquinone, tretinoin), Galderma, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/021112s016lbl.pdf