Pigment treatment starts with diagnosis
Melasma is one common cause of facial pigmentation, but not every brown patch is melasma. Pigment may also come from acne inflammation, sun damage, medications, irritation, lentigines, or other causes.
The American Academy of Dermatology notes that melasma often appears as brown or gray-brown patches and can be influenced by sun exposure and hormonal factors.
Hydroquinone is common, but not automatic
Hydroquinone is a common prescription treatment for melasma, and the American Academy of Dermatology notes that it is applied to the skin to help even skin tone. Hydroquinone is no longer available over the counter in the United States, which is one reason patients often need clinical review rather than random product shopping.
That does not mean hydroquinone is right for every patient. Pregnancy status, breastfeeding, skin sensitivity, irritation history, skin type, prior use, duration of therapy, and diagnosis all matter.
Non-hydroquinone approaches also matter
Non-hydroquinone options may include azelaic acid, kojic acid, vitamin C, retinoids, and other pigment-control strategies depending on the patient. The American Academy of Dermatology lists azelaic acid, kojic acid, vitamin C, tretinoin with a mild corticosteroid, and triple-combination cream among treatment options that may be used for melasma.
Light protection is not optional. The American Academy of Dermatology recommends broad-spectrum SPF 30 or higher and notes that zinc oxide, titanium dioxide, and iron oxides are often recommended for patients with melasma.
How CutisRx fits
CutisRx is built for patients who want pigmentation reviewed clinically instead of guessing between brightening products. Patients choose the pigmentation pathway, complete the intake, upload photos, and receive board-certified dermatology review when clinically appropriate.
Available in eligible U.S. states except Alaska, Mississippi, and New Jersey.
FAQ
Is hydroquinone the strongest melasma treatment?
Hydroquinone is a common prescription option, but “strongest” is not always the same as “best.” The right plan depends on diagnosis, safety, tolerance, and long-term maintenance.
Can melasma be treated without hydroquinone?
Sometimes. Non-hydroquinone options and strict light protection may be part of a plan depending on the patient.
Why does sunscreen matter so much?
Sunlight and visible light can worsen melasma and trigger recurrence. Protection is a core part of treatment, not an optional add-on.