“Doctor, I’ve heard that topical hydroquinone is the Gold standard treatment for pigmentations like melasma in Singapore, but I’ve also heard mixed feedback about it online.
Is it really the best option?”
This is a common question I get from patients who may have heard or read about topical hydroquinone to treat skin pigmentations.
Increasingly more and more melasma and pigmentation patients are switching over to topical creams like hydroquinone when their laser treatments are unable to achieve their desired lightening results at times.
However, with so much information (and misinformation) floating around, it’s no surprise that people are confused about hydroquinone. I understand one may be tempted to try out skincare recommendations on the internet, especially when countless beauty tips, products and even aesthetic treatments are just a click away.
However, relying solely on online advice can be risky, especially without the knowledge of your specific skin problems and skin types through a proper assessment.
Hydroquinone works by blocking or inhibiting an enzyme called tyrosinase (1), which is essential for melanin(pigmentation) production in the skin. As such, it lightens the hyperpigmented areas of the skin over time.
“But wait, if hydroquinone is so good, are there side effects?”
In reality, there is no perfect treatment for skin pigmentations in which one can enjoy superb and jaw-dropping results that come with ZERO risks of side effects. Though hydroquinone is incredibly effective, like any medication, it comes with its own set of pros and cons including potential side effects.
Thankfully, these are quite manageable if you use them correctly and responsibly under a doctor’s supervision.
The most common side effect of using hydroquinone is skin irritation (1,4). This may manifest as redness, peeling, dryness, or a stinging or burning sensation. But if you experience any of these symptoms, don't panic!
How to handle it?
Skin irritation is often caused by applying the topical hydroquinone over-zealously or too frequently, or getting excessive sun exposure.
To minimise irritation, you can test patch by using the cream every other night to give your skin time to adjust while maintaining a proper skincare routine using a high-quality moisturiser to keep your skin hydrated. Additionally, remember that applying sunscreen daily to protect your skin from sun’s UV damage is also key to preventing skin irritation.
These steps can troubleshoot and reduce the likelihood of irritation significantly, which is not really a big issue after all.
A misconception that often follows also includes that the irritation of hydroquinone per se can worsen pigmentations like melasma. This is not a common occurrence, compared to how melasma can be worsened even more with excessive sun exposure or inappropriate lasers done.
Occasionally, you might notice that the normal skin surrounding your pigmented spots lightens as well, creating a temporary whiter “halo” effect. While this can be concerning, it’s assuring to know that this is reversible once you discontinue the use of hydroquinone.
How to handle it?
The key to avoid this side effect is to apply the cream with precision, ensuring that it is confined within the pigmented areas you want to treat.
Here’s a tip to make it easier: using a cotton Q-tip bud for more controlled application can help with this. Also, taking your time, and being careful with the application can make a big difference in achieving the best results without affecting the surrounding skin.
Often brought up is an uncommon side effect of hydroquinone known as ochronosis (1,3,4,5), whereby the skin paradoxically develops a persistent bluish black hyperpigmentation.
Ochronosis is caused by prolonged, and unsupervised use of hydroquinone for several years (1,3), yes for years!
How to handle it?
The typical treatment duration of hydroquinone for skin pigmentation is usually for several months only (6), and certainly NOT FOR YEARS!
If your duration of hydroquinone usage is limited and controlled under supervision with your skincare doctor, then the risk of this side effect is minimized and low. If you need a little extra assurance, then regular check-ins with your doctor can help monitor your progress and ensure the treatment remains safe and effective for your skin.
“With great power comes great responsibility”
Hydroquinone has been proven in the medical field over the decades to treat skin pigmentation like melasma. Despite the few potential side effects mentioned, hydroquinone remains the Gold-standard treatment for pigmentation when used correctly. The key is for you to take personal responsibility to use topical hydroquinone sensibly;
When abiding by these basic and sensible hydroquinone usage measures, you can reap the full benefits of your melasma and pigmentation clearance, which far outweigh the risk of side effects mentioned above.
So, if you’re troubled by your melasma and pigmentations, and looking around for a treatment that has proven to work, topical hydroquinone is a great option. Just be sure to use it responsibly!
MBBS (Singapore)
GDFM (Singapore)
Dip. Pract. Dermatology (Cardiff)
Accredited by Singapore Medical Council for Medical
Aesthetics Procedures
Dr. David has more than 15 years of medical experience and has done over 30,000 aesthetics lasers and treatments under his belt.
If you’d like to know more about hydroquinone or discuss your pigmentation or melasma concerns, feel free to WhatsApp me at +65 9822 2989 or call us at +65 6222 2262. You can also email me at askdrdavid@onefaceclinic.com, and I’ll be happy to help!
Best Regards,
Dr David Ng C. H.
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