Thank you for your question.
There recently had been a lot of buzz regarding the safety of hydroquinone and its potential carcinogenic risk, however, this potential association has not materialized or been proven, and has not stopped physicians from using this bleaching chemical. It is safe, and nearly all dermatologists use it. You can get hydroquinone in the standard 4% cream from your pharmacy via prescription, or even have it compounded into an 8-10% cream. Just be careful not to overdo the bleaching effect with the higher strengths.
Tretinoin is safe and comes in maximum strength of 0.1%. It is a standard treatment in anti-aging regimens and is used in a variety of melasma treatments.
The best choice for melasma is Triluma. This is a prescription consisting of hydroquinone, fluocinolone, and tretinoin. In my experience, Triluma reduces melasma much better than any laser, peel, or other cosmetic treatment. It also surpasses using hydroquinone alone, and hydroquinone-tretinoin combinations.
Discuss these options with your dermatologist, and good luck treating your melasma!
