I have melasma and I have a strong hydroquinone formula (10%) from my derm; it turns my face orange-ish after a while. Why?

Question

My derm gave me a strong (10%) hydroquinone formula to get my melasma under control and then we plan to switch to something less concentrated, but I notice that after I use it for a few weeks my face starts to look really orange. Is this common? Is it because the formula is so strong or could it be interacting with something else? I use a prescription retin-a at night also (seperate formulation) and then just an estee lauder night cream.

Jason Emer, MD · Answer

i suggest cosmelan peels followed by clear and brilliant laser, microneedling/PRP, and skin care with those who have melasma.  Best, Dr. Emer.

Jeff Angobaldo, MD · Answer

Thank you for your question.  I would suggest doing a fractional treatment for melasma.  Apply hydroquinone morning and evening two weeks prior to your treatment.  The fractional treatment would help to suppress the discoloration and improve texture of your skin along with shrinking your pores.

Raffy Karamanoukian, MD, FACS · Answer

Dark spots on the skin are caused by sun UV exposure, hormonal load, birth control pills, and genetics. If you’re thinking about dark spot correction or melasma correction, you would be best advised to start with creams that control the production of melanin before starting lasers or chemical peels. I recommend Melarase creams first for pigment correction, followed by a protocol of lasers, chemical peels, exfoliation, IPL, and pulsed dye laser. 
  
 
  
Recommended Creams: Melarase Brightening Kit
  
MelaClenz
  Melapads
  Melarase AM
  Melarase PM
  Replenish Retinoid Cream
   
  
Best, 
  
Dr. Karamanoukian
  
Realself100 Surgeon

Shehla Ebrahim, MD · Answer

Many women suffer from melasma but there is not a treatment available right now that is 100% effective. Lasers can be effective but they are only temporary.I believe the best option is to treat melasma with topical creams, chemical peels and then maintenence with other possible options as needed.If you have a prescription that is turning your skin orange it could be becoming oxidized. Speaking with the pharmacist regarding efficacy is your best option.

David E. Berman, MD (retired) · Answer

The Picosure laser is the best treatment for melasma. you should plan a minimum of 3 treatments, each spaced a month apart. You will need to use a strong sunblock since sun exposure may cause it to return. You should stop any active skin agents, 3 days before your Picosure treatment.david berman md

I have melasma and I have a strong hydroquinone formula (10%) from my derm; it turns my face orange-ish after a while. Why?

Answers (6)