It depends on where you live, but here’s a general breakdown:
🔍 In the United States:
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Yes, you now need a prescription for all hydroquinone products (even 2% strength), due to the 2020 CARES Act, which removed it from over-the-counter (OTC) availability.
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Before 2020, 2% hydroquinone was available OTC, and 4% required a prescription.
🌏 In Other Countries:
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Some countries still allow OTC hydroquinone at low concentrations (typically up to 2%).
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Examples: Certain Asian and African countries may still sell 2% hydroquinone OTC in pharmacies or beauty stores.
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Stronger strengths (4% or higher) almost always require a prescription or are regulated as drugs.
⚠️ Important Considerations:
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Hydroquinone is effective for treating hyperpigmentation (like melasma, dark spots, PIH), but long-term use or improper application can cause:
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Skin irritation
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Worsening pigmentation (especially without sunscreen)
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Rare side effect: ochronosis (a bluish-black skin discoloration)
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It’s usually recommended for short-term use (3–6 months max) under medical supervision.
✅ Alternatives (often OTC):
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Azelaic acid
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Tranexamic acid
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Niacinamide
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Alpha arbutin
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Kojic acid
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These are gentler and available without a prescription in most countries.