Is it safe to use hydro-cortisone 1% on face for 6-8 weeks in various cycles?

I have used a strong cream containing Hydroquinone 10% + tretonin and steriod for six weeks. I want to use it again. In the past 5 years I have used steriods few times. First for six months when I tried pigmanorm sold in UK, then for about 2 weeks 2 years ago, and now more recently 2 months ago for six weeks. I want to know if it's going to cause any damage to my skin? why is steriod necessary for this cream?

Doctor Answers 1

Steroid creams and prolonged use.

Melasma 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.

I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams and steroid creams. Bottom line is that the 10% HQ you are applying is on the higher end than most would prescribe, and yes, at that strength irritation can occur, hence the steroid. Stay guided by your dermatologist as to the period of time, as they would monitor your skin carefully. I personally would say 4-6 weeks would be safe, but then would drop the dose down after that. 

I usually start my patients on laser (low dose Q switch or Picosure) a few weeks after they commence on creams.

In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help.

All the best,

Dr Davin Lim
Laser, surgical and aesthetic dermatologist
Brisbane, Australia


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