PRESCRIPTION STRENGTH HYDROQUINONE PRODUCTS
Opaque with partial sunblock
- Eldopaque Forte*
- Eldoquin Forte* Cream
- Melanex Solution
- Soloquin Forte* Cream or Gel
Absolutely strict sun avoidance or protection is imperative since the ability of the sun to darken melasma is much greater than the ability of bleaching medications to lighten it. The following sun protection measures apply both on sunny and cloudy days because ultraviolet skin-darkening rays of sun reach your skin even through clouds.
Hats and Non-Opaque Sunscreens:
Every day that you are outdoors for even a few minutes, apply a non-opaque sunscreen. The label of sunscreens includes an SPF (Sun Protection Factor). Pick one with an SPF of 30 or greater.
Extra protection can be obtained by wearing a hat that shades your face. Do not rely exclusively on hats, however, because reflected light will still reach your face while wearing a hat.
When significant outdoor exposure is unavoidable, the best method of protection is an opaque sunblock. Opaque sunblocks contain large amounts of zinc oxide, titanium dioxide, or red petrolatum. Examples include the following trade names: Afil cream, Maxafil cream, RVPaque, and Zinka cream.
Opaque Cover-up Cosmetics:
These also act as effective sunblocks if applied thickly. This gives a “made-up” appearance. Examples include: Dermablend (by Dermablend), Covermark (by Lydia O’Leary), Continuous Coverage (by Clinique), Pan-Stick and Pan-Cake. The first two provide the heaviest coverage. If these are used, separate sunscreen products are necessary. A separate information sheet is available about these products.
*Eldopaque Forte brand of hydroquinone contains a partial opaque sunblock. However, an additional sunscreen should be used with it, since it is not a totally opaque sunblock.
**Solaquin Forte brand of hydroqinone contains a non-opaque sunscreen. If this brand is used, it should be supplemented with a regular high SPF sunscreen that will provide better sun protection.
The most important step we can all take in skincare is protecting ourselves from the harmful effects of the sun's ultraviolet (UV) rays. Any dermatologist would agree that the smartest ways to protect yourself are to limit your intense sun exposure during the peak hours of 10 am-2 pm, wear protective clothing and hats when possible, wear sunglasses that block UV light, and generously apply a broad-spectrum sunscreen to all our exposed skin, and avoid artificial tanning beds.
It’s sunny outside, so you apply sunscreen. But what should you do if the forecast calls for cloudy skies? We recommend you apply sunscreen then, too.
The reality is since we can’t see or feel the intensity of UV light that comes from the sun, it’s difficult to know when and to what extent it’s damaging our skin. Though protecting our skin from the sun’s ultraviolet rays is something we tend to be more mindful of in the sunny, summer months, UV radiation can also be present when it’s cooler outside and even on cloudy days, too, when the sun isn’t necessarily shining bright.
So how much sun is too much?
Intensive and frequent sunbathing, as well as any type of prolonged exposure to the sun (working or playing outside, for example) without sunscreen is just simply too much for your skin to handle. Not only does it put you at increased risk for skin cancer, but you’re also more likely to see early signs of skin aging like wrinkles, dark spots, and loss of skin elasticity.
The truth is, sunscreen should be your last line of defense for protecting your skin. Let’s be clear, you should definitely use sunscreen daily, and when you’re exposing your skin to the sun for a prolonged period of time, you should reapply sunscreen often, as well. However, it’s best to combine sunscreen with other forms of sun protection to protect all of your exposed skin from the damaging effects of the sun’s harmful rays.
The physicians and providers at Dermatology Consultants in Atlanta, Georgia recommend you consistently use the following forms of sun protection:
- Limit your exposure to the sun and minimize the time you spend outdoors, especially between 11 am and 3 pm.
- Wear long sleeves and long pants if you must be outside when the UV index signals great potential for sun damage.
- Consider sun-protection clothing with UPF (ultraviolet protection factor) rating of 30 or above.
- Protect your eyes with UV-blocking sunglasses
- Wear a wide-brimmed hat that covers the entire top of your head and shades your face, ears, and neck from sun exposure.
- Use a dermatologist-recommended sunscreen product that’s at least SPF of 30 or higher.
Exposure to the sun has been associated with melanoma, non-melanoma skin cancers (basal cell and squamous cell carcinoma), and photo-aging (wrinkling, fragile skin, and spotty dyspigmentation (so called “liver spots”). Both melanoma and non-melanoma skin cancers are more common in those with light skin, light hair, and blue eyes, those who sunburn easily, suntan poorly, or freckle with sun exposure.
There is good evidence that the risk of both melanoma and non-melanoma skin cancers is increased with increased UV exposure, although they differ in the way that UV exposure causes them and this influences prevention. Non-melanoma skin cancers are most strongly related to lifelong chronic UV exposure, whereas melanoma correlates best with episodic UV exposure and blistering sunburns.
UVA & UVB
There are two forms of ultraviolet (UV) light to protect against: UVA and UVB. UVA is present throughout the entire day (not just the peak sun hours), and comes through glass and clouds. UVA plays a key role in skin wrinkling, leathering, and skin cancer promotion.
UVB are burning rays present in greatest amounts during midday. UVB rays play a major role in skin cancer promotion and photoaging.
The sun protection factor (SPF) number on the sunscreen lotion is a guide as to how long you can stay in the sun before risking sunburn. Recent studies have shown that most people apply sunscreens too thinly and therefore the SPF is probably less than what it says on the bottle.
“Waterproof” on the sunscreen label indicates that the protection is effective for four 20-minute swims. “Water resistant” is effective for two 20-minute swims. Reapply more frequently if perspiring excessively or toweling off frequently. Whichever form of sunscreen is chosen, it must be applied 20 to 30 minutes before being exposed to the sun. A new component of sunscreens, Parsol or Avobenzone, extends the protection from UVA and is advisable.
Choosing a sunscreen is an important part of your complete sun protection program but remember it is only one part! Sunscreens are typically divided into two broad categories: physical and chemical. Physical sunscreens such as titanium dioxide and zinc oxide actually reflect and scatter ultraviolet light, while chemical sunscreens act as protective filters by absorbing ultraviolet light.
Patients with sensitive skin may benefit from using sunscreens with no dyes or perfumes. Patients with acne or oily skin should use sunscreens that include “hypo-comedogenic or non-comedogenic” on the label. These words mean that this product will be less likely to clog skin pores and contribute to acne.
Types of Sunscreen Vehicles
- Oils: The most effective sunscreen ingredients are oil-based. They spread easily and have good water resistance. However, they are greasy and messy, cost more, and are easy to spread too thinly (which reduces their SPF).
- Emulsions: These are creams or lotions and are the most widely used sunscreen vehicles. They feel good and are easy to spread. The difference between creams and lotions depends on how much oil is used in the emulsion and therefore how viscous the product is.
- Ointments: These are unpopular because they are thick and greasy. Their use is restricted to activities involving prolonged water exposure such as surfing.
- Gels: The water-based gels do not feel greasy or occlusive and are popular with people with oily skin and those who are more physically active. They are difficult to apply uniformly and can be irritating. Alcohol-based gels are more water resistant but can sting, especially around the eyes.
- Sticks: Great for localized areas such as the nose and lips.
- Aerosolized Sunscreens: Usually oil based. Are easy to use but apply unevenly.
Recommendations for proper sun protection
- Apply before going out. It takes about 20 minutes for the active sunscreen ingredients to fully absorb into the skin.
- Apply enough (about one ounce for an adult body). The effectiveness of any sunscreen depends on the amount applied.
- Reapply frequently. Sunscreens become inactivated over time and they also get rubbed, sweated and washed away. Reapply every two hours and after swimming for maximum effect.
- Use a broad-spectrum and high SPF product of at least SPF 15 that contains both UVA and UVB.
- Don’t rely on sunscreen alone. Use sun protection such as hat, sunglasses with UV protection, long-sleeved clothing. Beware of reflectivity from sand, snow, cement and water. Utilize the shade.
- Don’t use sunscreen as an excuse to spend more time in the sun. Limit child’s UV exposure by decreasing time in the sun during peak sun hours (10 a.m. to 3 p.m.). Individualize interventions based on child’s skin color, susceptibility to burns, family history and presence of moles.
- Babies under six month sold should be kept out of direct sunlight and have adequate clothing for physical protection. Most recommend sunscreen for infants over six months. Selected use in younger infants is not harmful but should rarely be necessary because they should not be exposed to direct sunlight.
The broad-spectrum test measures a product’s ultraviolet A (UVA) protection relative to its ultraviolet B (UVB) protection. Sunscreens that pass this test may be labeled as “Broad-Spectrum SPF (value)” on the front of their label. For broad-spectrum sunscreens, SPF values also indicate the amount or magnitude of overall protection. Broad-Spectrum SPF products with SPF valued higher than 15 provide greater protection and may claim additional uses. Only broad-spectrum sunscreens with an SPF value of 15 or higher can claim to reduce the risk of skin cancer and early skin aging if used as directed with other sun protection measures. Non-broad-spectrum sunscreens and broad-spectrum sunscreens with an SPF value between 2 and 14 can only claim to help prevent sunburn.
Source: U.S. Food and Drug Administration
Last updated : 2/10/2023