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How long do you allow patients to use hydroquinone 4% since melasma is a chronic disease that can last for years? Do you use "drug holidays"?

Pigmentary Disorders

You. Hydroquinone and hydroquinone holidays, as I like to call them, are important. Hydroquinone is not something you should ever tell your patient. Hey, go use it for six months to a year and come see me in a year. No, doesn't work like that. You need to use the hydroquinone in a systematic fashion with an on off regimen when needed. Twelve to 16 weeks initially. I'll have a new patient come in. They get no refills. They get pictures at baseline, pictures at follow up. They're counseled on side effects, and then we go into second line topicals after that. So hydroquinone holidays are critical, in my opinion, especially at preventing irritation and okranosis.

How long do you allow patients to use hydroquinone 4% since melasma is a chronic disease that can last for years? Do you use "drug holidays"?

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