What happens when you stop using hydroquinone cream?

Question: My doctor gave me a prescription for hydroquinone ( 4%) cream.  It’s helping control my post pregnancy dark splotches, but I’ve heard bad things about  it.  How long am I able to safely use it? And what happens when you stop using hydroquinone cream?

Answer:  Hydroquinone is one among those medications that we like to hate. It’s been around for many years and is really  the ONLY ingredient that has been approved by the FDA for skin lightening consistent with Sinai dermatologist  Dr Gary Goldenberg, you’ll safely use hydroquinone cream for  up to 3 months at a time. albeit its working, you would like to require a 3 month drug holiday after the initial treatment.  If you would like to return to the present popular skin lightener, you’re back to a 3 month on and three month off schedule. However if  it hasn’t worked within the first three months, it’s probably  never getting to help your skin and it’s time to undertake something else.

How Does Hydroquinone Cream Work?

Hydroquinone blocks production of melanin by blocking the assembly of an enzyme that’s necessary for the assembly of the   dark pigment. It doesn’t  break down existing pigment but prevents new melanin from forming.  During the three month treatment period the prevailing darkened skin  cells  are  shed naturally and therefore the hydroquinone prevents new melanin from developing within the fresh new  skin cells.

Getting the simplest Results From Hydroquinone Cream

Before starting hydroquinone treatment, it’s important to understand  how your skin will react to treatment. to seek out if your skin is sensitive, dab a little amount on the inner surface of your forearm. If no itching or redness develops in 24 hours then you’re good to travel. To hurry up the advantages,  some experts recommend employing a glycolic cleanser or moisturizer to  help  speed up turnover  of  pigmented skin cells.

You can find 2% Hydroquinone cream on pharmacy shelves, but the 4% concentration is  available only by doctor prescription.  Your doctor also can prescribe  hydroquinone that’s combined with other skin brighteners. For instance Glyquin contains 4% hydroquinone with 10% glycolic acid.  Triluma may be a triple threat  skin lightener with hydroquinone cream to prevent melanin production, Retin A to hurry up cell turnover and a light steroid to keep things calm.

Problems with Hydroquinone

There is a dark side to hydroquinone ( no pun intended).  Dr Goldenberg warns that prolonged use  has been related to  the development of blue-black pigmentation (called ochronosis) that’s  very hard to manage. This is often usually seen in Africa and could be thanks to the presence of other ingredients within the  local skin lightening  formulations like phenol and mercury.  There also are reports of cancer appearing in animals  treated with hydroquinone cream, but  no studies have shown this connection in humans.

One final thought: you want to apply a 30-50 SPF sunscreen when using hydroquinone.  This ingredient acts by blocking new melanin production and if the skin is consistently exposed to new UV rays, there’ll be no improvement.   Skin  cells have long memories,  and  just  one unprotected sun filled  day can trigger new melanin production and more pigmentation. Trust me  this does happen.  I undid   three months of Tri Luma treatment with a morning on the beach.

The bleaching effects of hydroquinone cream appear more pronounced within the areas not suffering from melasma. Meanwhile, the dark marks of melasma show no improvement after that. In fact, the active melanocytes within the affected areas become resistant to hydroquinone, the patient’s hyperpigmentation in these areas worsens.

That is what happened to a 58-year-old female patient from India who was treated with melasma at our clinic in 2001. At that point, she was treated successfully with hydroquinone 4%, and hydroquinone mixed with retinoic acid, followed by a chemical peel to the papillary dermis. A decade later, after having obtained branded hydroquinone 4% and retinoic acid products from the online and therefore the black market, she returned and was diagnosed with rebound severe melasma (epidermal and dermal) that didn’t respond but worsened by her continuous hydroquinone cream use.

What happens when you stop using hydroquinone cream

I like to recommend that after not quite five months of hydroquinone application, all patients should cease using this drug for 2 to 3 months. This enables melanocytes to stabilize (so they will withstand external and internal factors which may otherwise increase their activity) and restore the skin’s natural melanin. During this phase, patients can use other lightening agents, then resume hydroquinone if necessary afterward.

Some dermatologists may prefer to treat resistant melasma by increasing the hydroquinone concentration. Instead, I even have found that patients respond well to aggressive application of hydroquinone (4%) plus retinoic acid, combined in equal parts. This mix tends to not bleach the skin, but to accelerate attainment of a more natural and even color tone. Once the skin’s color has evened out after up to 5 months of treatment, I even have my patients discontinue use of this mixture and switch to retinoic acid alone for 2 to 3 months; then patients resume hydroquinone cream application if needed.

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