How Do I Use Hydroquinone 4% and Tretinoin 0.025% to Treat Melasma?

I would like to know when do I use both medications: at night? what would I use first? is neutrogena liquid soap a good choice for washing face befor use of medications? Thank you

Doctor Answers 4

Melasma, hydroquinone and tretinoin cream

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When first starting hydroquinone and tretinoin creams, alternate them at night so your skin slowly become accustomed to them.  Use hydroquinone only on the brown spots and the tretinoin cream all over your face.  If you are tolerating them, increase treatment to every night.  If tolerated, also use the hydroquinone in the morning.  You must use SPF 50+ and avoid the sun.  Neutrogena or any mild cleanser is a good choice for washing your face.

You should consult with a board certified dermatologist who can prescribe more potent fading products for you and determine if you are a candidate for glycolic peels or laser treatments.

Toronto Dermatologist

Treating Melasma

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Ideally for your melasma you will have a proper assessment and management plan by your dermatologist. The soap is fine and won't affect things either way. I would use the hydroquinone in the morning, with sunscreen overtop and the tretinoin at night time after washing. As well, you can obtain a prescription for a combination cream which includes both ingredients along with other fading ingredients to be used simply at night time - see your dermatologist for this "Kligman formulation."

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

Follow prescribing doctors recommendation.

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HQ and tretinoin are excellent treatments for improving discoloration. These two products at bedtime, along with SPF and antioxidants daytime, are the most recommended precription agents for hyperpigmentation. Triluma has both HQ and tretinoin in ONE product, so many doctors recommend this product for excellent results.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

Use of skin bleaching regimen for melasma

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Typically you would wash the face and apply the medications at night prior to retiring to bed. You should be religious about the daily use of sunscreen and avoid sun-exposure. You may experience irritation and redness and for this reason most prescribers advise combining this regimen with a topical steroid.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.