Telangiectasia due to use of 10% hydroquinone, is it temporary? Can I reuse the same cream?

Hi Mandy - it's really difficult to say if the telangectasias you developed are permanent without seeing you in person. If it is just red blushing that may improve over time when the product is discontinued, but if there are dilated red blood vessels (streaky little red lines) those are unlikely to improve on their own. You should go back to the doctor who prescribed you the product and see what they suggest for further steps. Best of luck!

You do need to see a melasma expert- there is a variant of melasma that can be very vascular- modulation of VEGF receptors with T. acid with the 3 other methods described below can help this form of melasma. Its complex to understand but if you see a laser dermatologist they can guide you regarding treatments. I avoid vascular lasers, or yellow light lasers as they may produce too much heating of your melanocytes, and prefer medical modulation of your vessels. Melasma is a very common cause of skin pigmentation. It can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours. This forms the foundation of all treatments. 

I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams or Meladerm. I start my patients on laser (low dose Q switch or Picosure) as this has shown to decrease pigment production by decreasing the activity of the cells that produce pigment. Laser itself is not aimed at ‘blasting’ pigment, but to slow down the rate of melanin production. Another laser I use is the Clear and Brilliant in the 1927 Permea setting combined with creams. IPL should never be used to treat mixed melasma as it often worsens the condition (this is termed ‘Rebound Melasma’) 

In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient according the type of melasma. Majority of patients will have mixed dermal and epidermal melasma. Approach melasma as a medical condition and not a cosmetic concern, and the success rate will be much higher. 

See a Board Certified Laser dermatologist with a special interest in disorders in pigmentation as well as one who has experience in treating all skin types, including darker Ethnic skin. 

All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia.