How long can I safely use hydroquinone as pre-condition for laser treatments?

Question

I'm an African American (Fitzpatrick type 5) and my aesthetician recommends a series for 6 Clear+Brilliant Original treatments for rejuvenation. I'm prescribed hydroquinone to pre-condition my skin for 4 weeks before my treatment. Since my treatments are spaced 1 month apart, do I have to use hydroquinone for 6 months straight? I heard using hydroquinone for too long can cause ochronosis? I need a second opinion on this. Thank you.

Harold J. Kaplan, MD · Answer

Hello BLS.  If your hydroquinone is 4% or under, then you should be able to use this for a 6 month period.  Ochronosis is a very rare side effect of hydroquinone usage and we have seen it most often in other countries where patients are using high doses of hydroquinone for extended periods of time to actually lighten their natural skin color.  Also sun exposure simultaneously can play a part in the development of ochronosis.  So, if you are staying out of the sun and using 4% hydroquinone, your risk of experiencing Ochronosis should be very, very low.

A corollary to your question would be why the organization is using clear and brilliant for you.  If you want rejuvenation effects without the possibility of hyperpigmentation, then a q-switched Nd:Yg laser would likely be a better option.  It gives you the same heat and collagen stimulation effects but because it uses a different wavelength (1064) designed for dark skin types, the risk is very low for side effects like the ones you are trying to avoid with clear and brilliant.  Best of luck.

Raffy Karamanoukian, MD, FACS · Answer

If you are prone to discoloration, use a skin lightening agent. In my office, we recommend HQ holidays with the administration of a non-HQ dark spot corrector such as Melarase PM Arbutin. You will find that this will help your discoloration.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

you should def pretreat with hydroquinone and enlighten peels. you should add appropriate skincare and aerolase.

this is post inflammatory hyperpigmentation/melasma/discoloration that needs cosmelan or enlighten peels at home which we can do virtually and send to your home along with aerify peels regularly, vivatia foam, restorsea 10x, faith essence serum, and cosmelan 2 cream.

Hyperpigmentation from any type needs a combination approach of peels like cosmelan, enlighten and aerify,  lasers like clear and brilliant and aerolase or laser genesis, radiofrequency like venus viva, and constant skin care and sun protection.  Bimonthly facials with silk peel dermalinfusion is essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin.  If you have acne you can do additional treatments and peels to get more improvement.  I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.

How long can I safely use hydroquinone as pre-condition for laser treatments?

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How long can I safely use hydroquinone as pre-condition for laser treatments?

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