Combined melasma formula guide
How to use the prescribed hydroquinone, tretinoin, kojic acid and niacinamide compounded formula on its limited schedule.
How to use
- 01
Step 1
What it is and how it works
The validated compounded formula contains hydroquinone 4%, tretinoin 0.025%, kojic acid 2% and niacinamide 4% in a pharmacy-defined light gel-cream or emulsion. It targets confirmed melasma through complementary effects on pigment and skin renewal.
- 02
Step 2
Apply it as prescribed
Apply a thin layer only to the prescribed melasma patches on 2 nights per week. Use on clean, fully dry, intact skin and avoid the eyes, lips, nose folds and mucosa. Wash your hands afterwards and use only the labelled 30 g preparation.
- 03
Step 3
Skin care and interactions
Apply broad-spectrum SPF 50+ every morning and reapply during exposure. Do not add another hydroquinone, retinoid, acid, scrub, hydrogen peroxide or benzoyl peroxide to the same area unless reviewed. Keep cleansing and moisturising simple and gentle.
Dose schedule
- 01
Step 1
Timing and review
Use on 2 nights per week for 3 months exactly as prescribed. Review tolerance at 4–6 weeks and response at the end of 3 months. Do not increase the frequency, extend the course or request a repeat formula without clinical and pharmacy reassessment.
- 02
Step 2
If you miss an application
Apply it when you remember unless the next scheduled application is near. In that case, skip it and continue as usual. Do not apply extra product to make up for it.
Side effects
Local irritation
Mild redness, dryness, stinging or peeling can occur, especially at the start. Use a gentle moisturiser and follow the prescribed adjustment plan. Stop and seek advice if the reaction is marked or persistent.
Darkening or blue-black marks
Stop and request assessment if the skin becomes persistently darker or develops blue-black marks. Prolonged hydroquinone use can cause ochronosis. Do not use a cream or gel that has turned dark or blackish.
04 · Do not use if
Do not use this treatment if
- You are allergic to hydroquinone, tretinoin, kojic acid, niacinamide or the final vehicle
- You are pregnant, trying to conceive or breastfeeding
- The area has ochronosis, a suspicious or changing lesion, open wounds, eczema, marked irritation or sunburn
05 · When to contact your doctor
Contact your doctor if
- Facial swelling, breathing difficulty, widespread blistering, eye pain, light sensitivity or altered vision — seek urgent medical care
- You become pregnant or think pregnancy is possible — stop the formula and contact your clinician
- Persistent burning, swelling, cracks, crusts, worsening pigmentation or blue-black marks
Storage
Keep the compounded preparation in its labelled container, out of children's reach. Follow the pharmacy's storage conditions and beyond-use date; these depend on the final vehicle. Do not transfer it to another container.
What to expect
Pigment changes are gradual and recurrence is common without daily photoprotection. The formula is deliberately limited to 3 months. Use comparable photographs at review and expect the clinician to plan a break or a simpler maintenance routine rather than continuous use.