Can I Use Bleaching Cream (Topical 4% Hydroquinone) and Have Dermabrasion at the Same Time

Hello,

  I agree with Dr. Portuese that dermabrasion is not the best treatment for pigmented areas on the face.  Dermabrasion works very well for elevated or depressed scars and for deep creases around the mouth “smokers lines”. 
For my patients with localized areas of hyperpigmentation, I start them on 4% hydroquine for 6 weeks.  If there is improvement, then we continue using the hydroquinone for another 6 weeks.  If the skin is still too pigmented after a trial of hydroquinone, I recommend performing a TCA peel in the office.  A 35% TCA peel should only be performed by a physician and is quite a bit stronger then most resurfacing options available in a medical spa, such as Obagi blue peels, microdermabrasion, glycolic acid peels, ect. 

Regardless of the resurfacing option that is chosen, I make daily use of sunscreen a very important part of the treatment plan.  Sunscreen should be both UV-A and UV-B protective, and preferably contain a metal alloy, such as zinc or aluminum.  I recommend that my patients apply sunscreen every morning, regardless of the forecast.  It is important to recognize that many of these pigmented areas are due to sun exposure.  Especially in San Diego, the value of daily skin protection cannot be overstated.

Yes, it is actually a common combination. The two together will aid in exfoliating the upper-most layer of your skin and the dark area with it is helped by the use of Hydroquinone. It is recommended that you repeat your dermabrasion treatments every 4-6 weeks to achieve optimal results.

Dermabrasion is not used to improve pigmentation on the face.  A dermabrasion may cause further hyperpigmentation and darkening, especially if the patient is on hormones or gets sun exposure.  For a glycolic acid burn at a mini spa continue to use the hydroquinone to reduce the hyperpigmentation.