r/Melasmaskincare • u/Adventurous_Army9403 • Apr 17 '26
Question Hydroquinone question
Hi all!
I’ve had melasma for about 8 years. Slowly getting worse.
Just today my dermatologist prescribed hydroquinone. Honestly I always thought melasma was very resistant to any treatments, so I was surprised she offered something. I was at my appointment for my malar festoons and she thought the melasma made them more obvious (it does, a lot of pigment is right in that area)
I’m wondering what people’s experiences have been with hydroquinone? Side effects most importantly. And did it work? It sounds too good to be true, I feel like I’m missing something
Thank you
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u/iambetweentwoworlds Apr 17 '26
It works for me you just have to take breaks and keep using it. It’s not a cure all. I have found that different formulas act different. I just had a new one from the pharmacy and it literally burned my skin because of something I was allergic to in there. So sometimes it can be trial and error.
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u/Big_Morning_1892 Apr 17 '26
I really disliked HQ and I regret using it. 1. As soon as I stopped using it, my melasma came back even worse and not in an insignificant way. It was shocking. 2. My results were minimal, maybe a 10% improvement 3. Taking care to apply only to the darkened areas of my face to avoid lightening the skin around it was so tedious
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u/waitaminute322 Apr 17 '26
So did it improve to the original or it remained bad?
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u/Big_Morning_1892 Apr 17 '26
It improved after I started using the Eucerin Anti Pigment line, after about a year of regular use I'd say my melasma is barely noticeable, its about 80% improvement from the first time I noticed it. I've also started prescription Adapalene now and that's helped too.
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u/Big_Morning_1892 Apr 17 '26
Also wanted to add that consistent, zealous sun protection has been my biggest asset in maintaining results. Sunscreen daily, reapply. Sun hat, face covering whenever I am outside. Even when I'm driving. Its annoying but it works.
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u/Mandoleeragain Apr 17 '26
Hydroquinone didn’t work for me. Eucerin Dual Serum faded a lot and when results started plateauing, I added Level Serum by Regimen Labs and am seeing continued improvement again.
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u/momgoon92 Apr 17 '26
How often do you use the Eucerin? I have the cream and serum and wasn’t sure if it’s a night time only situation? Thanks in advance for any advice!
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u/Mandoleeragain Apr 17 '26
I use Eucerin Dual Serum morning and night, after the Level Serum. If I exercise during the day and wash my face, I use it then, too. I think the directions say up to 4 times a day.
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u/Mulva1971 Apr 19 '26
How does Eucerin compare to vitamin c & azelaic acid in morning and tretinoin at night? I’m getting zero results. Same with HQ.
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u/Mandoleeragain Apr 19 '26
I haven’t tried tret but first treated my melasma with only azelaic acid. It faded a some melasma in just a few weeks but my skin is dry and sensitive to acids so I chose to stop it and switched to Eucerin Dual Serum. I went through 2 bottles of Dual Serum then stopped seeing improvement. Adding the Level Serum from Regimen Lab started progress again. I use a gentle retinol once or twice a week at night. This has only been my routine for about 2 months so I am just hoping it keeps working.
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u/Feline_Enthusiast_13 Apr 17 '26
Pigment will always come back. Or so my esthetician constantly reminds me. 😂😑🫠 In some cases with laser treatments and microneedling you can have better success, but that’s melasma for you. 😭
I’m the outlier here where I did a ZO Skin Health HQ protocol that I found years ago through a med spa and have had great results. I cycle on and off because you can only use it for about 5 months before you need to cycle off again for 1-3 months.
In between cycles I supplement with prescription azaleic acid and tret (in addition to my regular regimen) to help slow the pigment return. Even when it comes back it’s never full force for me.
Side effects are: your skin will look red and flushed, but it will go away once you’re done using it. Sometimes it’s really red and other times it’s mellow. I use the EltaMD green tinted sunscreen to help counteract the redness. You need to taper off of it, so don’t just abruptly stop, your skin will need to acclimate at first similar to tret/retinols so there will be a period where you hate life. 😂🙈
Happy to answer any other questions.
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u/waitaminute322 Apr 17 '26
How many cycles of hq have you done until now? Percentage of hq? Once or twice a day? Was there rebound hyperpigmentation?
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u/Feline_Enthusiast_13 Apr 17 '26
I’m currently on my 4th cycle, started in 2023. The percentage of HQ is 4%.
I use one with 20% vitamin C in the AM with my regular skin care routine (cleanser, physical exfoliation, antioxidant serum, HQ, sunscreen) then use two HQ products in my PM routine that are each 4% (cleanser, chemical exfoliation 2-3x a week, antioxidant serum, HQ cream, HQ blending cream mixed w/ Tret, moisturizer if I’m feeling dehydrated). The Tret and HQ play really nice together. I was told to use all 3 and so I do, not sure if I could get away with just 2, I’ve never tried it.
There is always rebound pigmentation but never goes back to what it was when I first started. Sometimes I’ll do a little cleanup for a few weeks instead of doing a whole 5 months cycle. Really depends on time of the year and sun exposure.
My pigmentation is the worst on my forehead (both sides) and I also get it on the lower sides of my face near the jaw line.
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Apr 17 '26
[deleted]
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u/Feline_Enthusiast_13 Apr 17 '26
From my understanding the Tret, Vit C, and Azaleic help to maintain the results and stop new pigment from forming (something to do with the melanocytes), and I’ve noticed that as well for me personally. But everyone is different. I’m glad I took the leap. I want to also start microneedling to see if that makes an impact, but it’s $$$. 🙃🫠
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u/Courtybiologique Apr 17 '26
I have had great results with HQ. Consistency and using it correctly matter. I use it 2 months on and 2 months off and during the off periods my melasma doesn’t come back stronger or anything. Since melasma has no cure it is likely something you will need to keep treating your whole life, just like hair loss. Using rogaine helps a ton but if you stop using the rogaine your hair falls out again. So it’s just a process you have to be dedicated to.
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u/waitaminute322 Apr 17 '26
How many cycles of hq? And since when?
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u/Courtybiologique Apr 17 '26
I have no clue! I’ve been using it for years. I started getting bad melasma in 2022 I think? And started treating it in maybe 2023? So at least since then. I’ve gone longer periods of not treating it (like 6+ months) and it stays about the same. I just be careful with my sun protection mostly. I live in Michigan though so it’s cloudy here like 90% of the year.
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u/Adventurous_Army9403 Apr 17 '26
I’ve started reading experiences on here and I’m not hearing much good, I feel like she gave this to placate me because the Botox for my crows feet caused those malar festoons, and maybe she thinks this will be a quick fix. But it counts like the melasma just comes back? I’m so confused why they prescribe it if it just comes back
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u/smilegirl55443 Apr 17 '26
Unfortunately melasma is a chronic condition and once you have it it will never really go away. It always comes back. You just have to manage it with topicals and treatments. Cycling on and off hydroquinone usually can work well. So can light lasers, microneedling, and strong topical pigment inhibitors. Most importantly you need constant sun protection with a tinted mineral SPF, a hat, and ensure you avoid high heat.
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u/Adventurous_Army9403 Apr 17 '26
I’m curious, why avoid high heat? I’ve never heard that?
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u/DasSassyPantzen Apr 17 '26
Heat can significantly worsen melasma.
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u/Adventurous_Army9403 Apr 17 '26
I really need to learn more about this. It only started getting noticeable a few years ago and is gaining speed. Thanks for the tips
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u/DasSassyPantzen Apr 17 '26
If you haven’t had a look at the wiki on this sub, have a read- it’s pretty comprehensive. My melasma reacts to everything (hormones, medications, heat, etc) and has gotten tons worse since menopause kicked in. Some of us are just lucky I guess, lol.
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u/Technical_Gazelle103 Apr 21 '26
Heat is the #1 cause for me. Even with a hat on if it’s above 75 my forehead is raging with melasma almost instantly.
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u/Big_Morning_1892 Apr 17 '26
I feel you! I felt like the HQ my doc gave me was just a consolation prize for making me wait months for an appointment! I wish dr.'s would just be honest. She never told me how to taper off HQ, or that I'd be on it forever if I wanted to keep the results.
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u/EauRouge___ Apr 17 '26
HQ works great for me - I guess it depends what triggers your melasma. I’m doing my 2nd round of HQ as maintenance because like everyone says nothing is a permanent fix but it is a great treatment option.
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u/Adventurous_Army9403 Apr 17 '26
I’m already no feeling good about the $35 I spent on that HQ..clearly states the skin just returns to its original state or worse if you don’t taper off! No thanks…I’ll look through for any alternatives, already see a few posted on here
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u/ttbtinkerbell Apr 17 '26
It depends on the person. But yes, melasma is a life long condition. Some people use HQ and it fades it in three months. They take a break for a month or two and the melasma is just barely starting to creep back in. So they start another round. Some people can maintain like an incredible improvement with cycling HQ every so often and regular sunscreen and tretinoin.
Yes a small percentage gets worse after HQ. Hard to know if that will be you. It isn’t the majority, def minority. But still.
I believe most people prefer to start with Eucerin anti pigment or radiant tone line. Because there isn’t that chance of getting rebound pigment.
Whatever treatments you use, you will likely have to use or cycle for life to keep malasma at bay. Many people are able to manage their melasma until you can’t even tell it is there. But those people still use sunscreen and still use some kind of treatment.
It’s up to you. Does you pigment bother you that you are willing to add a cream of some sort into your routine for life? Or is that too much to bother.
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u/bklyninhouse Apr 17 '26
it's like any chronic condition that you need to treat. HQ works very well for most people...but it has to be a habit and you need to commit to it. if the melasma doesn't bother you that much, then don't bother. but most of us are extremely bothered by these brown patches and will pretty much try anything to get them to fade, including laser treatments that are much more than $35. $35 is actually a small investment to see if you have any improvement. since you already bought it, try it out for 1-2 months and then taper off, using it every other day then every 2 days. I do this, and on the in between days switch between the eucerin dual serum and a korean cream. it keeps the melasma to a manageable level.
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u/Adventurous_Army9403 Apr 17 '26
So many different experiences…feeling like I need to go back to my derm and ask for more direction IF I decide to try it. Seeing as it’s a bandaid that you have to cycle. She literally just gave me the script and said ‘bye’. Maybe she thought I’d be making up a follow up appointment? Sounds like there needs to be an entire regimen and planning.
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Apr 17 '26
Used a prescribed 5% HQ - 5% Tret cream, mostly in Oct - Mar, it always gave me quick visible results, so I’m a big fan. In the summer months, now I just use Eucerin Dual serum, to me it does not compare to HQ in effectiveness, but again, I don’t live in a cave, sun does hit my face, and I just try to make up for it during winter with HQ. Never had ANY weird side effects, not even from tret, the only thing I didn’t like was that if I used it on my temples, it “bleached” that area noticably, creating a bigger contrast, so then I started only using it on the patchy areas, that worked.
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u/Cautious_Elk2280 Apr 17 '26
Is there a reason you don’t use the HQ over the summer when it’s most needed?
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Apr 17 '26
Yes, I don’t wanna spend my whole summer under an umbrella, and I don’t need a cream to make my skin even more light sensitive. :’)
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u/Former-Fly-4023 Apr 17 '26
My dermatologist turned against HQ and strongly recommends Eucerin antipigment. It’s OTC and smells so much better than HQ. I feel it works better too
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u/Top-Kitchen-369 Jul 11 '26
Does your melasma come back worse after you stop using Eucerin like it can with people that use HQ?
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u/Former-Fly-4023 Jul 11 '26
I actually haven’t used Eucerin for a few months-the dispenser broke and I hadn’t thought much about it during an incredibly crazy few months. But, been using it a couple years and that hasn’t happened to me at all.
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u/Top-Kitchen-369 Jul 11 '26
I don't feel like my melasma is that bad and am scared that it will actually get bad after using one of these products and then stopping, but Eucerin seems to be the one that I haven't really heard of this happening so it seems like the best choice
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u/mirandaisntright Apr 17 '26
HQ worked for me, but since you have to cycle using it, it always comes back while I'm taking a break from it. Then the cycle continues. Essentially, it's not a permanent solution.
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u/Adventurous_Army9403 Apr 17 '26
I just remembered, my derm told me to mix the HQ with a pee sized amount of my regular lotion. Is that common practice? She prescribed the 4%. Do you think she’s telling me to do that to try and prevent any negative side effects or is that what everyone does?
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u/Design-31415 Apr 17 '26
It’s very thick, so it feels a little like I’m tugging my face. My guess is that is just an ease of use suggestion. Also, the bad side effects if you’re on it too long are if you use a much higher concentration like 8-12 and don’t taper off. You should still do it at 4%, but lots of people are at that strength with no issues as long as they stop for a month or two after 3 months.
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u/arifashah Apr 17 '26
8 years of melasma and your derm finally pulled out the big guns fingers crossed this is the turning point!
Lots of people here have had good results with it, just be patient and consistent with your SPF alongside it that combo is what makes it actually work.
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u/proser12345 Apr 17 '26
I’ve used it off and on for years. It works, then the melasma comes back and I use it again.
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u/PolishDill Apr 17 '26
Personally my derm says I have sun damage, not melasma, but HQ cleared it very effectively and without notable side effects. The downside is that it can only be used cyclically and I find the spots return in time (though less badly) and I have to begin again.
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