The Spot Cream formulas Nurture, Erase and M+ contain hydroquinone. In general, it is best to use hydroquinone products for four months continuously and then take a break for a few months. Even if you have remaining refills, it is important to take a break and resume your refills after the break. During your break, you can use The Spot Cream HQ Free+, The Anti-Aging Night Cream, or The Spot Peel Boost.
Continuous use and overuse of any products containing hydroquinone is not recommended, since it carries a rare risk of causing very stubborn and difficult-to-remove bluish black discoloration of the skin, called Ochronosis. Ochronosis is very rare but can happen especially to African American, Latin or Asian patients. The risk can happen with any concentration of hydroquinone but more likely with higher concentrations. If you notice a blue/gray discoloration of your melasma, stop using The Spot Cream and send us a photo. Also, if your melasma is not improving while on The Spot Cream, you may need to see a dermatologist in person.