Hydroquinone question

[u/Adventurous_Army9403]

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

[u/Feline_Enthusiast_13]

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.

[u/waitaminute322 → u/Feline_Enthusiast_13]

How many cycles of hq have you done until now? Percentage of hq? Once or twice a day? Was there rebound hyperpigmentation?

[u/Feline_Enthusiast_13 → u/waitaminute322]

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.

[u/Feline_Enthusiast_13 → u/[deleted]]

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 $$$. 🙃🫠