Thanks for sharing your journey! I’m so glad that combination is already working and your doctor’s advice sounds excellent. It really highlights the importance of having both the treatment and protocol personalised for you and I suspect it’s why you’re already seeing good results. Good luck with the treatment and please send an update when you’re done ☺️

Did you experience redness? I am asking because I did. I am scared to apply it again.

@rvmg6297 initially, I did but I had to change my facial wash and moisturizer. Now, I use vanicream facial wash and vanicream facial moisturizer with hyaluronic acid. So at night, I wash my face, next apply the hydroquinone mix, last step is the moisturizer. I don't do any other serums or retinols on the area I apply it to.

@@profmj7630 I use cetaphil gentle cleanser and cetaphil PM moisturizer. Is this gonna go away? And also can I still use my tretinoin at night?

Thanks Nads! really appreciate your support as always 😊 It was such a delight to see in the virtual clinic. You also had great results because you were very diligent with the protocols and patient too! Thanks for the great suggestion! I will do a body sunscreen video and put it up.

Really good question so thanks for asking! Wouldn’t normally recommend using in the under eye area (apart from some exceptions) and for the lips it can be effective depending on the type of hyperpigmentation, where it is in the lip and quality of the lip tissue. If used as part of a targeted treatment plan (with an exit/maintenance program) then the risk of it coming back or worsening can be massively reduced. I’ve written a detailed guide to this on our blog cityskinclinic.com/hyperpigmentation-lips-treatment/

You’re super welcome Tania ❤️ you should reach out to your doctor asap to check why the dark patch hasn’t responded and also to prevent you from over treating your face which carries risk of ochronosis. They may need to amend your protocol, stop the hydroquinone and/or taper it down.

So sorry to hear what you've been through but rebound hyperpigmentation can happen on hydroquinone usually if your skin is exposed to the sun. Rest assured though! You will eventually get your skin colour back. Just follow what your Derm is recommending. It will take longer because Kojic acid is a very weak pigment suppressor compared with Hydroquinone. It does work though and the Tretinoin will help it. Please make sure you protect your ski from the sun and avoid anything that can irritate it.

Sorry to hear about your skin reaction and hope it’s better! It sounds like irritation but could also be allergy. The hydroquinone content is high and might be causing a lot of the irritation although it could also be due to the other ingredients if you haven’t used then before. It’s worth speaking with your Derm as you might tolerate starting with a lower strength first and gradually build up to that or they might remove some of the other ingredients in the compounded formula. Alternatively they may advise on a protocol that reduces some of this absorption initially (e.g sandwich method etc). Ultimately if it is an allergy or your skin can’t tolerate it then over the counter products may be best.

@@CitySkinClinic Thank you for your response. I sent my pictures to my derm and she said that my skin is adjusting and it is not a bad irritation. My skin is adjusting to it. Hopefully she is right. I git scared so I stopped using it after I applied it the first time.

That’s awesome news! You did the right thing to stop using and check with your Derm. That’s what we always recommend our patients do and then we can advise them on whether to continue or change protocol etc. I hope it settles down soon for you ☺️

Hey there, no this isn’t normal. You should stop using and urgently speak with your medical practitioner to find out what’s happened and how to rectify it!

Thanks Aish. I’m afraid I can’t provide specific medical advice as that would be irresponsible. I would however recommend reaching out to your medical provider since they should tell you what would be the best way to use it to treat your problems but also even out your skin tone and avoid patchiness. This will depend on a number of factors which they’ll evaluate based on your skin assessment. Good luck ❤️

Hi there, you will need to speak with your treating practitioner as Tretinoin and hydroquinone are prescription medicines and each person’s protocol has to be adapted to their skin type, needs, medical history etc. Each patients routine need to be personalised to get good results and avoid damaging the skin.

@@CitySkinClinic hello doc i went to my dermatologist he said apply it twice per day for 3 months then to do a 3 month break, im scared it might irritate me so is it fine if i only use it at night for the first 2 weeks

Hi, I;'m so sorry to hear that. So rebound hyperpigmentation can happen due to the sun but also if you use hydroquinone for a long period which can make the skin resistant to it or irritates the skin or destabilises the pigment making cells. All these can cause rebound hyperpigmentation. In this case, it may be best to take a break from hydroquinone and checkin with your practitioner. They can make sure its actually rebound hyperpigmentation and not something else. Based on that they can recommend whether to restart hydroquinone (and when) for a short course or to try another treatment. In general, they should also provide you with something to use after the hydroquinone to maintain your results.

Are you wearing a sunscreen when you use hydroquinone? Maybe that would help you avoid the rebound effect. Or you could wear a hat or cover the area with longer shirts/pants.

@@profmj7630 yes I do use sunscreen daily

Great question! So at the moment Hydroquinone is not classified as a carcinogen for humans based on the studies to date. However there are ongoing studies to assess whether it causes cancer. That being said there are other serious risks of using hydroquinone (especially in high concentrations and for prolonged periods). That’s why it is a prescription only medicine in the UK to ensure that it’s used safely and appropriately for short periods.