Can Hydroquinone Make Melasma Worse?

Can Hydroquinone Make Melasma Worse featured photo

If you’ve been spending some time looking for skin-lightening products to treat melasma, chances are that you’ve come across hydroquinone. But also, you’ve definitely read countless articles about the controversy surrounding it, which makes you wonder, can hydroquinone make melasma worse? Will it bleach your skin?

Hydroquinone works so well in clearing melasma off the skin. But it can also cause temporary darkening. It’s not because the medication makes it worse, but it’s only due to the accumulation of broken-down melanocytes on the surface of the skin.

That said, in some cases, further darkening can stem from a range of factors. In this post, we’re going to talk about how hydroquinone works and the different ways that it can further darken treated skin. We’ll also delve into its potential side effects and what you can do to maximize its benefits.

What Is Hydroquinone?

Typically used as a lightening agent and medication to treat hyperpigmentation, hydroquinone inhibits melanin production that causes skin pigmentation such as freckles, sun spots, and melasma. It’s been around for 50 years and is considered as the gold standard for treating different types of hyperpigmentation.

However, unlike other depigmentation agents, hydroquinone does not “bleach” the skin. This is a common misconception, when in fact, hydroquinone works at a cellular level.

As you know, the overproduction of melanin (skin’s natural pigment) in the melanocytes causes unwanted pigmentation. Hydroquinone works by “messing” with the processes within the skin’s pigment cells (melanocytes). It interferes with the life cycles in the melanocytes while increasing cellular breakdown.

It basically offers a double-sided approach, but it still needs to be used with caution.

A Word of Caution

Hydroquinone-containing products effectively reduce the amount of overactive melanocytes, but using them involves a lot of care before and after treatment.

First, you must do a consultation with a board-certified dermatologist to address your skin condition. Doing so will help them determine the best treatment for you. If you indeed can use hydroquinone, they can prescribe it to you in concentrations up to 2%.

Anything higher than that could result in resistance, and that’s when it gets worse. When the hyperpigmentation becomes resistant to the medication, it can lead to overproduction of melanocytes.

To achieve consistent results, make sure to cycle your use. Allow at least 4 to 8 weeks in between treatments in order for your skin cells to recuperate and adjust. Doing this can also keep your skin from developing resistance to the medication.

It’s also highly advised to apply a broad-spectrum sunscreen. A broad-spectrum sun protection factor (SPF) of 60 should be enough.

Skin treated with hydroquinone becomes more sensitive to the sun, making it more prone to UV damage. Prolonged sun exposure also aggravates dark spots, so wearing your sunscreen should be second nature.

Can Hydroquinone Make Melasma Darker?

It’s not that it can make melasma darker. Keep in mind that hydroquinone does not remove or scrub melasma off your face. What it does is it only reduces the volume of hyperactive melanocytes, which die off in the process. So, when you stop using hydroquinone, the hyperpigmentation will return.

As the melanocytes die, they will gather on the surface of your skin, the way dead skin cells do. So, if you notice any further darkening on the treated area, know that your skin is going through the shedding process. It’s completely normal.

The pigments are dark, so naturally, they can make your skin look darker. It may bother you for a few weeks but it will usually go away and you should see gradual lightening.

But while you wait, find time to dedicate to doing your daily skincare routine. Use gentle cleansers to remove dirt and excess oil from your face. You may also want to invest in gentle exfoliants to speed up removing the dead skin.

Potential Side Effects of Using Hydroquinone

While hydroquinone works well in treating melasma, some of the controversies surrounding the medication might be true. For one, Hydroquinone is a metabolized Benzene, which is in fact a cancer-causing agent. The FDA banned the OTC hydroquinone in 2006 due to its relation to ochronosis in humans.

However, the medication has been used for half a century and there have been no reported cases of skin cancer from topical treatment. Hydroquinone is available for prescription only and it is safe to use topically.

In some cases, hydroquinone can cause some swelling and tenderness to the skin.

As the medication gets to work, it limits tyrosinase, which is a multifunctional enzyme that controls the production of melanin from tyrosine. If you have sensitive skin, this can cause swelling and tenderness, although this could also indicate that you’re using it in high concentrations.

Who Should Use Hydroquinone?

Hydroquinone works well for treating melasma in patients with skin tones on the Fitzpatrick scale of I to III. However, the medication isn’t really recommended for patients with medium to dark skin tones.

Treating darker skin tones with hydroquinone can trigger skin irritation and allergic contact dermatitis. Long-term use might result in permanent depigmentation and exogenous ochronosis.

It’s always best to consult with a board-certified dermatologist to help you choose the right treatment for your skin type. They can also help you prevent any further damage to your skin.

Other Treatment Options

While hydroquinone is the “gold standard” for treating melasma, it simply doesn’t work for everyone. Fortunately, there are several alternatives available, including:

  • Tretinoin
  • Niacinamide
  • Alpha arbutin
  • Alpha hydroxy acids (glycolic acid, lactic acid)
  • Beta hydroxy acids (salicylic acid)
  • Vitamin C (ascorbic acid)
  • Azelaic acid
  • Kojic acid

Most of these treatment options are used in chemical peels and can be purchased over the counter without a prescription. They can come with lesser risks and are found in a wide range of skincare products.

Key Takeaway

So, does hydroquinone make melasma worse?

The answer isn’t as simple as yes or no. Hydroquinone inhibits the overproduction of overzealous melanocytes in your skin. In a way, it does lighten melasma, but it doesn’t “bleach” your skin So, if you stop using the medication, there’s a high chance that melasma will come back. But it’s not because hydroquinone made the skin darker.

What makes it worse, however, will be the lack of care on your end. If you don’t use SPF, for example, the production of melanin within your skin pigment cells will aggravate your melasma. Using hydroquinone in high concentrations can also worsen the situation.

But overall, hydroquinone brings more good than bad if the treatment is carried out correctly. And we hope you learned something from this article. If you have more questions regarding the use of hydroquinone in the treatment of melasma, let us know and we’ll gladly help you. Thanks for reading!

Michelle Jackson
Michelle Jackson