Hydroquinone Cream Treatment - Application & Dosage

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Dark Spot Management

This treatment plan reviews the risks and benefits of the treatment we are recommending. Please make sure to read it and the manufacturer's pamphlet that comes with the medicine. The manufacturer's pamphlet contains the full information on interactions, side effects, and other important information you should know about the medicine before you start.


You have stated that you wish to take a topical medication to lighten dark spots. Hydroquinone 5% cream is applied as a pea sized amount for the whole face. Begin at bedtime for 2 weeks and if tolerating well can increase to morning and night. You may apply to just problem areas if they are small isolated spots or more diffusely to the whole face if the areas are more widespread. You will cycle on for a maximum of 4 months use of hydroquinone followed by at least a 2 month break to cycle off. This is to avoid chronic continuous use which can result in a rare side effect called ochronosis where the medication can stimulate new pigment production.


You will need to place a new one-time order. Hydroquinone is not available on a subscription plan.

If your symptoms aren't getting better after you start taking the medicine or if you develop new or worsening symptoms such as fever, chills, nausea, vomiting, or pain, you should see a doctor in-person and call or message us immediately. Furthermore, if your symptoms are not simply dark spots, then an in-person exam with a physician is necessary to determine a correct diagnosis.

Active Ingredients

This medicine contains the following active ingredients. If you are allergic to any of these components, similar components, or any of the others components listed in the manufacturer's pamphlet do not take it and call or message us immediately:

  • Hydroquinone 5%
  • Vitamin C 1%
  • Niacinamide 4%


This medicine may cause an allergic reaction if you are allergic to similar medicines or components. If you are allergic to any of the following, please stop taking the medicine and message your wisp doctor, or seek an in-person:

  • Hydroquinone
  • Niacinamide


We have evaluated your health history and the specific health information you provided us, however if anything changes and you develop or discover that one of these conditions applies to you please stop taking this medicine and call or message us immediately:

  • Pregnancy
  • Breastfeeding

Pregnancy and Breastfeeding

This is not recommended for use during pregnancy or breastfeeding due to the potential for side effects in the infant.

Emergency Side Effects

This medicine can cause dangerous and potentially life threatening side effects. If any of the emergency side effects listed in the manufacturer's pamphlet or those below happen to you please stop taking the medicine and call 911 or seek immediate medical help in-person:

  • Severe skin rash, blistering or changes
  • Mucosal (eyes, mouth) rash/peeling
  • Shortness of breath or wheezing
  • Pregnancy

Accurate Information

We have evaluated the specific health information you provided and are making our recommendations based on it. If you forgot to provide or incorrectly provided that information we may misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. If you need to clarify or update any information about your health you can message or call us anytime.

Treatment Failure

This treatment is not 100% effective. It may not work or may only partially resolve the condition for which you are seeking treatment. If the treatment is not working, or if you are experiencing new or worsening symptoms, give us a call or message us anytime. If it is an emergency call 911 or seek immediate medical help in-person. You may need to seek alternative treatment such as those listed below or in the follow-up plan.

Misdiagnosis or Delayed Diagnosis

There is also a risk that we may incorrectly diagnose or fail to diagnose the correct conditions that you may have, thereby affecting our recommendation for treatment. This risk exists with in-person care as well, but they may have additional clinical history, physical exam findings and tests to aid their evaluation. We use evidence-based practice guidelines and clinical decision making to try to minimize these risks. Here are some other diagnoses that we attempt to rule out:

  • Other benign causes for brown spots such as seborrheic keratoses.
  • Skin cancers - if any lesion concerns you for changing in size, shape or color please see a dermatologist in person for an exam under magnification.

Accepting or Declining Our Recommendation

We are recommending this treatment for you because the potential benefits of treatment outweigh the risks. You should evaluate this information as well as the manufacturer's pamphlet, and any input from your in-person healthcare team, or other relevant information to decide if this treatment plan is appropriate for you. You are free to decline our treatment recommendations although doing so may prolong symptoms and can be associated with other risks or negative outcomes.

Alternative Treatment

We have based our recommendation on your specific case and current medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can't provide. Message us or talk to your doctor in-person to discuss alternative treatments. Here are some other treatments or strategies that you might consider:

  • In-person dermatology appointment

Share with Your In-Person Healthcare Team

You can access your records anytime. We strongly recommend that you update your in-person doctor, pharmacist, and the rest of your healthcare team to let them know about any new medicines you are taking or other changes in your health.

You can also ask us questions anytime and we are happy to help you share any information about your health with your in-person healthcare team.