Hydroquinone

Hydroquinone is used in the treatment of:

• Hyperpigmentation

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Hydroquinone may be found in some form under the following brand names:

• Aclaro

• African Formula Skin Lightening

• Alera

• Alphaquin HP

• Alustra

• Claripel

• Complex B

• Dermarest Skin Correcting Cream

• Eldopaque

• Eldopaque Forte

• Eldoquin Forte

• Enlighten Me!

• EpiQuin Micro

• Esoterica

• Exuviance

• Fade Shades

• Glyquin

• Glytone

• Hydroquinone and Sunscreen

• Lustra

• Lustra-AF

• Medisilke

• Meditowel Illuminating

• Melanex

• Melanol

• Melpaque HP

• Melquin HP

• Melquin-3

• Metasol

• Nava-SC

• Neova Complex HQ Plus

• Nuquin HP

• Obagi Nu Derm

• Pigment Gel

• Porcelana Night Skin Lightening

• Proactiv Skin Lightening

• Rejuvaderm Fading

• Remergent HQ

• Scarguard Scarlight

• Solaquin

• Solaquin Forte

• Tri-Luma

• Viquin Forte

Depigmenting agent; structurally related to monobenzone.a h s

General

• Depigmentation varies among patients in completeness, time of onset, and duration; rarely completely reduces hyperpigmentation and some patients exhibit no response to the drug.a

• May require 1–4 months for depigmentation effects to occur.a Following discontinuance of hydroquinone, depigmentation effects usually persist for 2–6 months.a

• Avoid unnecessary exposure to sunlight during and after therapy.a b h p s

• Prior to initiating therapy, assess the risk of irritation or allergic reactions by applying a small amount of hydroquinone preparation to an area of unbroken skin.a b h m p s After 24 hours, examine test site; discontinue treatment if itching, vesicle formation, or excessive inflammation occurs; however, minor redness is not a contraindication for further treatment.a b h p s

Administration

Topical Administration

Apply topically to the skin as a cream, gel, emulsion, or solution.a b m p q s (See Sensitivity Reactions under Cautions.)

Limit application to an area equal to that of the face and neck or hands and arms.a s

For dermatologic use only; avoid contact with eyes.a b q s If such contact occurs, flush the affected eye(s) with copious amounts of water and contact a clinician.b

Not for oral administration.a

Apply hydroquinone cream, gel, emulsion, or solution (with or without sunscreens) uniformly to pigmented area and rub into skin.a b p s Do not rub cream containing opaque sunblocking agents (e.g., talc) into the skin.b h

If hydroquinone preparations without sunscreen agents are applied during the daytime, use sunscreen agents and/or protective clothing to minimize exposure and prevent repigmentation of treated areas; alternatively, apply these preparations only at night.a b h p q

Gently wash face and neck with mild soap, rinse, and pat dry before applying fixed-combination hydroquinone, fluocinolone, and tretinoin cream to affected area(s).q

Apply a small amount of fixed-combination hydroquinone, fluocinolone, and tretinoin cream to affected area(s), including about ½ inch of normal skin surrounding each lesion.q Rub lightly and uniformly into the skin.q Do not use occlusive dressing.q

Dosage

When the desired degree of depigmentation is obtained, apply only as often as needed to maintain depigmentation.a

Pediatric Patients

Adolescents >12 years of age: Apply hydroquinone cream, emulsion, gel, or solution (with or without sunscreens) uniformly to pigmented area(s) and rub in well twice daily, in the morning and evening.a b p s

If improvement does not occur after 2 months of treatment, discontinue the drug.b p s

Adults

Hydroquinone cream, emulsion, gel, or solution (with or without sunscreens): Apply uniformly to pigmented area(s) and rub in well twice daily, in the morning and evening or as directed by a clinician.a b h p s

Hydroquinone cream with opaque sunblock: Apply uniformly to the pigmented area(s) twice daily, in the morning and evening; do not rub into affected area(s).b h

If improvement does not occur after 2 months of treatment, discontinue the drug.b p

Fixed-combination hydroquinone, fluocinolone, and tretinoin cream: Apply a thin layer uniformly to the affected area(s) once daily, in the evening, at least 30 minutes before bedtime.q Continue daily for as long as the melasma lesions persist.q Discontinue treatment when melasma resolves.q

If melasma reoccurs, repeat treatment until condition resolves.q

Prescribing Limits

Pediatric Patients

Adolescents >12 years of age: Maximum 2 months of therapy if no improvement is seen.b

Adults

Maximum 2 months of therapy if no improvement is seen.b p s

Fixed-combination hydroquinone, fluocinolone, and tretinoin cream has been safely administered for cumulative ≥180 days.q

Special Populations

Geriatric Patients

Clinical studies of 4% hydroquinone cream did not include sufficient number of patients ≥65 years of age to determine whether they respond differently from younger patients. In general, dosage selection for geriatric patients should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, and/or cardiac function and of concomitant disease and drug therapy.

Absorption

Duration

Depigmentation effects usually persist for 2–6 months following discontinuance of therapy.a

• Tell all of your health care providers that you take hydroquinone. This includes your doctors, nurses, pharmacists, and dentists.
• After stopping this medicine, some of the color change may come back.
• If you have a sulfite allergy, talk with your doctor.
• This medicine may cause harm if swallowed. If hydroquinone is swallowed, call a doctor or poison control center right away.
• Avoid sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
• Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this medicine while you are pregnant.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Use hydroquinone as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Do not take this medicine by mouth. Use on your skin only. Keep out of your mouth, nose, and eyes (may burn).
• Wash your hands before and after use. Do not wash your hands after use if putting this on your hand.
• Clean affected part before use. Make sure to dry well.
• Put a thin layer on the affected skin and rub in gently.
• Practice good skin care and avoid the sun.
• Do not use coverings (bandages, dressings, make-up) unless told to do so by the doctor.
• Do not use on irritated skin.

What do I do if I miss a dose?

• Put on a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not put on 2 doses or extra doses.

Onset and duration of depigmentation produced by hydroquinone varies among individuals

Skin bleaching: Gradual bleaching of hyperpigmented skin conditions, such as chloasma, melasma, freckles, senile lentigines, and other unwanted areas of melanin hyperpigmentation

Animal reproduction studies have not been conducted with topical administration; the amount of systemic absorption is unknown.