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Home / Forms / Hydroquinone Consent Form

Hydroquinone Consent Form

Hydroquinone is used to lighten dark spots and help with hyperpigmentation. Accordingly, it is a skin-lightening agent that works by preventing the formation of skin pigment melanin.

Hydroquinone should not be used close to the eyes and lips. If you do get the medication in your eyes or mouth, wash out with water straightaway. If you experience a reaction such as itching, rash or vesicle formation occurs stop using Hydroquinone immediately.

While using Hydroquinone avoid the sun and ultraviolet exposure (e.g. tanning beds/booths and sunlamps). Use a sunscreen that contains zinc oxide or titanium oxide and with an SFP of 30 or higher for better protection. It is imperative you protect your skin while using hydroquinone.

Hydroquinone should not be used during pregnancy or while breast-feeding.

Patients with exotic skin or darker pigmented skin should be aware that using Hydroquinone longer than 3 months without a break can lead to darkening of the skin. Only apply hydroquinone to the affected areas of the skin twice daily (not more) or once if your skin is too sensitive for the treatment.

I have read and understand the above statement before signing this consent form. All of my questions regarding Hydroquinone and its risks have been answered before using the product.