Hydroquinone in cream, ointment, and gel: what it is and HOW TO USE the treatment

The hydroquinone is a chemical compound used to treat the skin, it is a bleaching agent with depigmenting properties. Used in the form of a cream, many dermatologists recommend it to reduce hyperpigmentation, facial spots, and other skin conditions.

What is Hydroquinone

Known as “1,4-dihydroxybenzene” hydroquinone cream or dermatological gel works as a skin depigmenting agent. It is good for removing dark skin when a single spot appears or when there are multiple skin patches.

Its action is depigmenting and its effects provoke the production of melanin and melanocytes, the transition of tyrosine and tyrosinase.

Properties

• Depigmenting.
• Skin whitening.
• To treat chloasma or dark dermal patches.
• Hydroquinone formula: C₆H₄(OH)₂.
• Molecular weight: 110.13 u.m.a.
• Melting point: 170.3 °C.
• Boiling point: 285 to 287 °C.
• Flash point: 165 °C.
• Autoignition temperature: 515 °C.
• Soluble in water: 5.9 g/100 mL (15 °C).
• CAS number: 123-31-9.

It is widely used as a skin treatment. Its most common uses are for treating spots on the face and other parts of the body. Hydroquinone cream and gel are very effective depigmenting agents. It works by reducing melanin in the skin, which, when produced in large amounts, darkens the epidermal tissue, forming spots.

In the treatment of Melasma or chloasma, the dermatologist may recommend applying a small amount topically. The properties and benefits include a reduction in skin tone, evening out dark areas with the natural skin color.

Soluble in alcohol, ether, and benzene, it can also be diluted in fourteen parts of water. Hydroquinone can be obtained by reducing quinone or p-benzoquinone.

Types of Hydroquinone

• Cream
• Gel.
• Ointment
• Hydroquinone 2 and 4.

Hydroquinone Cream

In this form, it should be applied topically, that is, on the skin. Its action removes the spots on the face. Its depigmenting properties eliminate the outer layer of the skin, forcing the regeneration of the epithelium.

Ointment

Known by this name as well as by the cream name, hydroquinone ointment is a solution used to treat hyperpigmentation and skin imperfections. It also shows good results as a treatment for scars.

The uses of the ointment are the same as those of the creams, meaning it works to treat Melasma, marks, hyperpigmentation of the skin, and skin aging.

Gel

Although its formulation differs from the previous ones, its applications are similar. In many scientific publications, the names “hydroquinone gel,” “cream,” and “ointment” are used interchangeably.

It should be mentioned that the differences lie in its oily base, though the uses and applications, as in the previous cases, are similar. Hydroquinone helps to remove excess melanin and damaged epidermal tissue.

Hydroquinone 2 and 4

This designation refers to its concentration, meaning hydroquinone 2 indicates that the cream contains 2% hydroquinone, and hydroquinone 4 refers to 4% of 1,4-dihydroxybenzene, which means the same.

A simple explanation is that for every 100g of cream, there are 2 or 4 grams of hydroquinone, the active ingredient.

How to use hydroquinone

1. Wash the skin with plenty of water.
2. Dry the area well before applying the cream, gel, or ointment.
3. Take a small amount and apply it to the skin twice a day. Ideally, once in the morning and once at night before bed.
4. Repeat every day until the spots on the face or body disappear.

You should use hydroquinone cream only on the affected area. It is not necessary to spread it beyond the area with excess melanin. To apply the cream, you can use your fingertips. Once applied, wash your hands with water and soap.

The usage time is several weeks. This period varies between individuals. Each person has a different number of spots and pigment groups, so the treatment time varies. Its action remains the same, but with greater melanin and skin pigments, it is necessary to apply the active ingredient for a longer time.

The maximum time is 6 months. Never exceed this period, as it may cause side effects.

What if there are no results?

Clinical studies indicate that in many cases, it takes several weeks to notice the benefits of hydroquinone on the skin. It is stipulated that after the second month of treatment, if there is no improvement, it is not working. So, if 8 weeks pass with daily use and no reduction in spots or some lightening of the skin, consult a doctor.

The effects last from 4 to 6 months after finishing the hydroquinone treatment. After this time, it is likely that the skin will darken again due to the formation of new melanin.

Should sunscreen be used?

Yes. It is very important to apply protection against UVA and UVB rays when applying hydroquinone cream. Its depigmenting properties weaken the connective tissue, and exposure to sunlight stimulates the formation of new melanin, which causes the skin to darken.

Since it should only be applied to specific areas, if you are exposed to the sun, these areas will accumulate more pigment in the skin, resulting in spots on the face, back, or treated areas.

It is advisable to use sunscreen with full coverage during the use of hydroquinone gel, ointment, and cream, as well as for the weeks afterward. This applies to both 2% and 4%.

Before and after effects

The vast majority of people notice positive results after several weeks. However, there is a small group that does not achieve the desired effects. Either because they need stronger treatments like laser for scars, which eliminates and reduces the depth of keloid or atrophic scars, or because the body blocks its effects.

In general, as stated, after 2 months of treatment, the results should be evident. We can say that hydroquinone before and after produces:

• Depigmentation.
• Skin lightening.
• Elimination of shallow scars.

Price of hydroquinone

At this point, it is important to differentiate the various products, as based on their composition, the prices of hydroquinone are:

• Hydroquinone cream at 2%: $20.
• Cream or ointment at 4%: $30.
• Depigmenters and facial cosmetics: from $20 to $60.

Keep in mind that medical use differs from cosmetic use. The concentrations are lower when added to facial cosmetics. It is very common for other active ingredients such as commercial name of kojic acid, retinoic acid, or avoiding administration after a mandelic acid peel to be present, as well as other depigmenting substances that remove the outer layer of the skin, dead cells, and the epidermal layers affected by excessive pigmentation.

Brand Names

• Hydroquinone ISDIN 2% gel.
• Eldoquin.
• Eldopaque.
• Neostrata.
• Hydroquin.
• Glico.
• Glyquin.
• Lustra.
• Solaquin.
• Ultraquin.
• Crema América.
• Nadona.

Contraindications

• Children under 12 years old.
• Open wounds.
• Irritated skin.
• Skin infection.
• Sunburn.
• Allergy to hydroquinone and ingredients in the product.
• Pregnancy.
• Breastfeeding.
• Peroxide solutions like hydrogen peroxide, benzoyl peroxide, etc.

It should be applied exclusively to the affected area, being careful not to reach any wounds or scratches. Also, special attention should be given to mucous membranes as it is very irritating. Do not use near the eyes.

In cases of sunburn or after sun exposure, it should not be used.

If you are pregnant, it is important to be cautious and always consult with your obstetrician or specialist. Retinoids and depigmenting compounds can cross the breast barrier and flow into breast milk, containing some active ingredients that may harm the baby or fetus if pregnant. Therefore, hydroquinone and pregnancy is a contraindication unless specifically indicated by a doctor.

Side Effects

• Peeling of the skin.
• Itching.
• Redness.
• Stinging.
• Temporary darkening of the epidermis.
• Brown spots on the nails.
• Dryness on the treated areas.

The nail stains disappear after a few days or weeks. If the remains are not properly removed when applying it to the skin, it may affect the keratin of the nails. This side effect of hydroquinone is not significant, although it is an aesthetic collateral damage. Wash your hands thoroughly after handling the cream or any product containing it.

If it is your first time using it, it is advisable to perform a patch test for 24 hours on an inconspicuous area, such as the inner forearm. If you have hypersensitivity to hydroquinone, you will notice an allergic reaction in that area. In that case, do not use it before consulting your doctor.

Tretinoin Hydroquinone

In some cases, the dermatologist may recommend the simultaneous use of several active ingredients, such as tretinoin and hydroquinone, and even with fluocinolone.

The use of a retinoid, a depigmenting agent, and a corticosteroid produces various effects on the skin. While there is a renewal of the tissue, there is a calming effect on the itching and elimination of the redness of the epidermis, softening the side effects of hydroquinone and also those of topical tretinoin cream. On their own, these active ingredients are quite irritating.

At the same time, because of the greater action, the beneficial effects for depigmenting the skin are more significant.

Use with Fluocinolone

When included in the formulation, it produces greater benefits as it counteracts the adverse effects of tretinoin. The properties of fluocinolone acetonide are to eliminate skin irritation and reduce inflammation caused by retinoids, both in the case of tretinoin and hydroquinone use.