Hydroquinone

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Mar 29, 2023

Warnings

Hydroquinone (Blanch) Risks, Warnings, and Complications

Hydroquinone topical can cause or worsen serious health problems in some people. Talk to your doctor or pharmacist about other treatment options if you are at increased risk of complications from hydroquinone use.

ALLERGIC REACTIONS: Hydroquinone cream contains sulfites and it can cause a life-threatening allergic reaction in people with sulfite allergy. Call your doctor immediately or seek emergency medical treatment if you develop a severe skin rash, hives, itching, chest tightness, or difficulty breathing after using hydroquinone. The risk of allergic reactions is higher in people with sulfite allergies and asthma.
OCHRONOSIS: Using hydroquinone can lead to ochronosis, which is a gradual blue-black discoloration of the skin. This is more likely to occur in people with darker skin tone and in those who use a high concentration of hydroquinone on a large area of the body for a long time. If you notice your skin color changing to blue-black, stop using hydroquinone and get in touch with your dermatologist or healthcare provider without delay.
INCREASED SENSITIVITY TO SUNLIGHT: Hydroquinone increases the sensitivity of your skin to UV rays in sunlight. If you don’t use skin protection measures like sun avoidance, sunscreen, and protective clothing while using hydroquinone, you can develop dark spots on your skin. The risk is higher if you are on other drugs that also cause photosensitivity. Avoid going outdoors between 10 am and 4 pm. Use sunscreen with at least SPF 30. Wear a hat and long-sleeved shirts and trousers to protect your skin. Also, avoid UV exposure from lamps or tanning beds. Do not use hydroquinone cream if you have a sunburn.
ADRENAL FUNCTION SUPPRESSION: The brand name product Tri-Luma contains a topical steroid called fluocinolone acetonide in addition to hydroquinone and tretinoin. Systemic absorption of the steroid medicine into the bloodstream can lead to reversible HPA axis (adrenal gland) suppression. This is more likely to occur if you use the cream over large areas, for a long time, over broken skin, or apply an occlusive dressing on the treated area. Symptoms may include cold sensitivity, difficulty sleeping, fatigue, depression and anxiety, and high blood sugar. Stop using Tri-Luma and tell your doctor immediately if you develop any unusual symptoms.

Precautions Before Starting Hydroquinone (Blanche)

Tell your health care provider if you are allergic to hydroquinone or any other medications. Your pharmacy can give you a full list of active and inactive ingredients in hydroquinone formulations.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, non-prescription drugs, vitamins, herbal supplements, and topical medications. This will help avoid dangerous interactions between your medications.

Give your doctor a complete medical history. Hydroquinone may not be right for people with certain medical conditions.

Tell your doctor if you are pregnant, could be pregnant, planning a pregnancy, or are breast feeding.

Precautions During Use of Hydroquinone (Blanche)

Keep all your healthcare appointments during your treatment with hydroquinone. Use hydroquinone exactly as directed by your healthcare provider. This topical medication is for short-term treatment (up to 8 weeks) of moderate to severe melasma. Do not use it for longer than prescribed. Remember, it can take up to 4 weeks for you to notice an improvement in your melasma.

Tell your doctor if you become pregnant while taking hydroquinone.

Hydroquinone (Blanche) Drug Interactions

Certain other drugs can affect how hydroquinone works. Possible interactions between hydroquinone and other medicines can increase the risk of severe adverse effects. The brand name product Tri-Luma contains three active ingredients which can interact with various other medications.

Give your doctor and pharmacist a list of all the medicines you take, including prescription drugs, OTC (non-prescription) drugs, dietary supplements, herbal products, and topical creams, ointments, gels, lotions, etc. Also, tell your healthcare professionals if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription medications.

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