Hydroquinone 4% Bleaching Cream: Whitening Products Work on Skin?

Bright and sunny summer days can feel great, but they can also lead to dark sun spots and other forms of hyperpigmentation. The good news is hydroquinone may help. You’ve likely heard a little about this popular skin lightening ingredient, but do you know what it is, what it really does, and the potential risks involved? Keep reading to learn all about this controversial topical solution and discover whether or not it’s right for you.

What is Hydroquinone?

Hydroquinone, commonly referred to as HQ, is a chemical agent proven to lighten dark skin and treat various forms hyperpigmentation, such as melasma, age spots, liver spots, and freckles. HQ cream works by blocking melanin production and the process that leads to skin discoloration.

Due to its effectiveness, HQ commonly found in several skin whitening products. In fact, in some products, it’s the only active ingredient. In others, it is combined with other substances for enhanced results. Nonetheless, it’s most commonly used as a topical solution applied via a cream.

HQ creams come in several different concentrations ranging from 2-10 percent depending on the severity of the darkened region. While two percent HQ creams are widely available over the counter, creams containing four percent or more must be prescribed by your physician.

History of Hydroquinone

HQ can be traced back to the 1960s. In 1961, a study was published by Dr. Malcolm Spencer in which 98 African American and Caucasian males were treated with different concentrations of HQ. The study lasted for four months, and the concentrations ranged from two percent up to 10 percent.

Some of the subjects who applied a five percent HQ cream experienced skin irritation, but the irritation went away when a two percent HQ solution was substituted. Nearly half of the participants experienced skin lightening, but there was more improvement noted in the Caucasian participants than the African American participants and those with darker complexions. This study provided the first documentation of HQ’s effectiveness and safety for clinical use.

Shortly afterwards, several more studies were performed, confirming that a safe form of HQ was quite useful in lightening skin color. In one study, two percent, three percent, and five percent HQ was used to treat age spots on the hands of both Caucasian and African American males. Once again, approximately 2/3 of the participants experienced some form of pigment suppression, and the authors of the study concluded that HQ was an acceptable skin lightening agent.

During this time, the results of another study were published. With this study, two percent and five percent HQ were applied to 56 people with hyperpigmented skin. According to the study, both concentrations of the HQ were equally effective at treating 80 percent of the subjects. While the study administrators found HQ did not completely treat hyperpigmentation, they did find it to sufficiently help most patients.

Since this time, numerous studies regarding the efficacy of HQ have been published, and despite its link to several health concerns, it has become the treatment of choice for dermatologists around the world.

How Does It Work?

Hydroquinone cream, or whitening cream, decreases the skin’s ability to create excess melanin, which is the natural substance responsible for giving skin its color. When evenly distributed, melanin can result in quite a nice tan. However, when too much melanin is created and clustered together, it results in brown spots known as age spots or liver spots. HQ bleaching cream interrupts this process and causes these spots to gradually fade away.

It works by decreasing the skin’s melanocyte numbers. Melanocytes are the building blocks of melanin, which is what gives your skin its color. In those suffering from hyperpigmentation, an above average production of melanocytes causes increased melanin production and darkened skin.

By controlling the production of these melanocytes, HQ is able to make your skin more evenly toned. However, it takes time. On average, it takes about one month for the ingredients to begin taking effect, but it can take several months of regular use in order to experience full results.

If you do not notice any significant visible results in two to three months of taking an over-the-counter HQ product, talk to your dermatologist. He or she may be able to provide a prescription to a higher strength HQ cream better suited to your needs.

Over-the-counter HQ products typically contain up to two percent HQ. Concentrations of four percent or more are available by prescription only and can help get rid of stubborn dark spots even sooner.

Where Can It Be Used?

Whether from the sun or a medical condition, dark spots can appear on the face, arms, legs, back, shoulders, and pretty much the entire body. While it is perfectly fine to use HQ on most body parts, there are some spots HQ shouldn’t be used.


The face is one of the most common areas for the application of HQ creams and topical solutions. As long as you follow the instructions and use a little common sense, your face should tolerate it just fine.

That being, pay careful attention to keep it out of your eyes. If not, according to the Journal of the European Academy of Dermatology and Venearology, you can experience pigmentation of the eye and suffer permanent corneal damage. Since this can occur if it comes into direct contact with the eye, make sure to avoid the eye area when applying HQ creams anywhere on your face.


The underarms of most people receive much less sunlight than the other areas of their bodies, making them whiter than the rest of their skin. However, for others, they can become darker for a number of reasons ranging from excessive sweating to shaving with the wrong razor. Still yet, hyperpigmentation or another medical issue may be to blame.

Regardless of the cause of your discolored underarm skin, there are several HQ creams on the market formulated to gradually lighten underarm skin. Just note, if your underarm skin is sensitive and easily irritated, an HQ cream may not be the best solution.

Intimate areas

Dark skin on the nipples, vagina, and other intimate areas is not uncommon. In fact, it’s perfectly normal for most. In addition to being naturally darker, these areas are also much more sensitive, so you should avoid using any HQ creams. Even OTC creams containing two percent HQ are not recommended.

Entire Body

HQ cream is safe to use for just about every area of the body except for the intimate spots. You can use it on your arms, legs, chest, or anywhere else with age spots or other discolorations you would like to minimize.

However, since the nipples can be an extremely sensitive area, make sure to avoid them when applying HQ cream. Also, once again, keep it away from your eyes if you are applying it to your face.

Using Hydroquinone Cream to Treat a Variety of Skin Conditions

HQ creams can be used to treat hyperpigmentation related to a number of skin conditions, including:

• Age spots

• Liver spots
• Sun spots
• Dark spots
• Acne scars
• Freckles
• Melasma
• Inflammatory discoloration from eczema and psoriasis

It’s important to note that despite HQ’s ability to gradually fade red or dark spots, it won’t help skin that is actively inflamed. For instance, while it can help reduce acne scarring, it won’t help with the redness associated with acne breakouts.

How to Use HQ Cream

When using HQ cream or any whitening cream, it’s important to carefully follow all of the product instructions. After reviewing the instructions, perform a small patch test in order to see your skin’s reaction to the cream and whether it will produce any unwelcome side effects.

To perform this test, rub a small amount of the HQ cream into the skin on the inside of your thigh or forearm. Next, cover the area with a large Band-Aid or small bandage and wash your hands to prevent discoloring your fingertips or staining your clothes. Then, leave it alone and check after 24 hours.

Slight redness is perfectly fine, but if the test area is itchy, puffy, or irritated in any way, don’t use the product. On the other hand, if you experience no adverse side effects, you should be able to make it a regular part of your skin care routine. When using HQ to treat hyperpigmentation, consistency is key. You should use HQ every day in order to experience maximum results.

As far as the application process is concerned, it should be applied after cleansing or washing your face but before applying moisturizer. Just apply a small amount evenly across the area you would like to lighten and gently massage it into the skin.

After it has absorbed into the skin, wash your hands. Then, apply sunscreen. Since UV exposure can actually reverse the effects of an HQ cream and make hyperpigmentation worse, it’s important to wear sunscreen while using it. Make sure to reapply throughout the day as needed.

Although consistency is important in order to achieve the best results, HQ shouldn’t be used for extended periods of time. If you see little to no improvement after using an HQ cream for three months, stop using it. If you do notice a significant improvement in your skin tone after three months, it’s okay to keep using it for an additional month. However, after four months, you should begin tapering off your use of HQ. You should never use it for longer than five consecutive months. If you want to use it again in the future, you should wait a few months prior to resuming use.

How to Buy Hydroquinone Creams

Depending on where you live, hydroquinone creams can be purchased online or at several brick and mortar drug stores and pharmacies. Despite being banned in Europe, there are several online stores selling different brands of HQ creams in a variety of strengths. If you live in the US, HQ creams under four percent can also be purchased over the counter at CVS, Walgreens, Walmart, and a bevy of other stores. Creams with an HQ concentration of four percent or more, however, require a doctor’s prescription. For the easiest way to buy Hydroquinone over the counter is by Amazon – below we picked out the highest rated / most reviewed Hydroquinone creams available.


Hydroquinone Safety, Side Effects, and Risk

Despite being banned in Europe, Hydroquinone has been deemed safe by the FDA for use in the US due to a lack of clinical evidence suggesting it is harmful to humans. Nonetheless, side effects like dryness or redness are certainly possible. This is especially true of you have sensitive skin. However, for most people, these side effects gradually go away as their skin becomes accustomed to the product.

That being said, for some people, the side effects of HQ cream can be much worse. While rare, it can cause ochronosis in some people after prolonged use. Ochronosis is a condition causing bluish or black pigmentation and papules. To avoid it, you should avoid using products containing HQ for longer than four months at a time.

As mentioned, people with dry, sensitive skin suffer more side effects. Conversely, people with normal or oily skin fare much better. The ingredient also works best on lighter skin tones. If you have dark or medium-toned skin, it may actually have an adverse effect and increase hyperpigmentation. Therefore, if you have darker skin, you may want to consult your dermatologist prior to use.

HQ Controversy

While HQ is currently deemed safe for use in the US, the history of the skin whitening cream is steeped in controversy. The FDA recognized it as being a safe and effective skin lightener in 1982. Several years later, however, it pulled HQ from store shelves amid safety concerns. Upon investigation, the FDA found that several HQ products contained mercury and other harmful contaminants. Since then, tighter controls have been implemented and the FDA recognized HQ in two percent concentrations as a safe over-the-counter skin lightening solution.

The controversy regarding HQ stems from its banning in South Africa several decades ago. At the time, the products in question contained mercury, glucocorticoids, and several other caustic contaminants. This explained the many side effects people were experiencing at the time.

Not long after, countries throughout the European Union followed suit despite the fact that HQ is not harmful when properly formulated. Even though there is now abundant research showing the safety and efficacy of HQ, it remains banned in Europe to this day.

Another issue with HQ that has stirred up controversy is its association with ochronosis, which is a skin disorder that causes the skin to darken. However, it’s worth noting that the development of ochronosis is extremely rare, and it only occurs when HQ is used for extended periods of time. This is why regular use of HQ should be limited to a maximum of three to four months. If you begin experiencing skin darkening, you should immediately stop using HQ and consult your physician.

Hydroquinone Cream Alternatives

If the controversy over HQ has you concerned, there are several other skin lightening and bleaching cream alternatives to consider. While they may not work as well, creams containing glycolic acid, azelaic acid, kojic acid, vitamin C, and retinoids will also lighten skin with regular use. The best kojic based whitening cream we found on Amazon.com is this one – it does not contain HQ and is therefore useful for intimate areas:

As is the case with HQ creams, you should check with your dermatologist prior to using any other skin lightening creams. Since many countries have poor regulations regarding the manufacturing of cosmetic products, you should also only choose creams made in the US.

Bleaching and skin lightening creams are also not the only options for treating hyperpigmented skin. While they are costlier, laser lightening and resurfacing, photo rejuvenation, tranexamic acid, chemical peels, and glutathione injections have also proved effective. However, each option has its own risks and side effects, so it’s best to consult your dermatologist in order to choose the best hyperpigmentation treatment option for you.

Like everything else in the medical field, one treatment may work well for one person and not the next. Nonetheless, HQ remains a staple solution for dermatologists treating hyperpigmentation. Despite its decades of controversy, it is still widely used to this day. Why? The answer is simple – it works.


Age spots and other forms of hyperpigmentation can be difficult to treat. While HQ cream may help reduce melanin production and lighten your skin’s dark spots, it isn’t ideal for everyone. Therefore, rather than taking any unnecessary risk, you should consult your dermatologist prior to using this powerful ingredient. This is especially true if you have sensitive skin or a naturally dark skin tone.

Despite its controversy, however, it remains a safe and effective skin lightening option for the vast majority of people suffering from hyperpigmentation. With proper consistent use, it should begin fading your dark spots in no time at all.







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