Tretinoin and Hydroquinone Safety

If you are concerned about Hydroquinone, there are non hydroquinone options such as Melarase AM that does not contain HQ. In our office, we recommend Melarase AM and Melarase PM for melasma improvement. Raffy Karamanoukian MD FACS

Hydroquinone and tretinoin are both relatively safe products.  The main concern with long term use of hydroquinone is in laboratory animals the product promoted tumor development.  In humans, this has not been proven.  Another concern with hydroquinone is the potential to cause onchronosis which is a darkening of the skin and typically occurs with higher concentration of hydroquinone.  Finally, hydroquinone can be drying to the skin and causing untoward textural changes to the skin.  For these reasons listed, my office does not recommend the use of hydroquinone for more than 4-6 months consecutively.  Tretinoin should not be used in pregnancy as this can potentially cause birth defects.  Hydroquinone also is not safe during pregnancy.  

Hydroquinone is safe when used properly and with a regimen of triretinoin and effective sunscreen. Kare Skin makes it easy by providing a system that includes all of the above. It is the All-You-Need Skin Brightening Kit. See the link below. Hydroquinone is very commonly used in everyday practice by skin specialists. 

I would definitely recommend that you use Retinoids and Hydroquinones for Melasma as they are safe and effective. Combining these creams with chemical peels is an extremely effectively way to reduce the melasma and have clear skin.  Strict sun avoidance is necessary to avoid the recurrence of melasma.  Please consult a board certified dermatologist who is an expert in Melasma for the best cosmetic results.  Best, Dr. Green

Thank you for your question.

There recently had been a lot of buzz regarding the safety of hydroquinone and its potential carcinogenic risk, however, this potential association has not materialized or been proven, and has not stopped physicians from using this bleaching chemical. It is safe, and nearly all dermatologists use it. You can get hydroquinone in the standard 4% cream from your pharmacy via prescription, or even have it compounded into an 8-10% cream. Just be careful not to overdo the bleaching effect with the higher strengths.

Tretinoin is safe and comes in maximum strength of 0.1%. It is a standard treatment in anti-aging regimens and is used in a variety of melasma treatments.

The best choice for melasma is Triluma. This is a prescription consisting of hydroquinone, fluocinolone, and tretinoin. In my experience, Triluma reduces melasma much better than any laser, peel, or other cosmetic treatment. It also surpasses using hydroquinone alone, and hydroquinone-tretinoin combinations.

Discuss these options with your dermatologist, and good luck treating your melasma!