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Head-to-head evidence comparison — which supplement is right for you?
Hydroquinone wins 2 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Mostly mechanism / observational
Top outcomes
Verdict
Mostly mechanism / observational
Top outcomes
Shared outcomes (1)
Outcomes where both Cysteamine (topical) and Hydroquinone have evidence — compare verdict strength side-by-side.
Topical cosmetic. Cysteamine 5% cream is typically applied once daily to areas of melasma as a short-contact treatment (left on for ~15 minutes, then washed off) to limit odor and irritation, with daily sunscreen. There is no oral or systemic use in this context. This library does not provide an ingestion protocol.
any
Cysteamine 5% cream (short-contact application)
Prescription topical. Hydroquinone is used at 2-4% (often as the triple-combination with a retinoid and a mild corticosteroid), applied to pigmented areas usually at night, in time-limited courses (commonly with treatment breaks) under clinician supervision, always with daily sunscreen. There is no oral or systemic use. Avoid indefinite continuous use because of ochronosis risk. This library does not provide an ingestion protocol.
evening
Hydroquinone 2-4% cream or the triple-combination (with retinoid + mild steroid), under a clinician
Throughout
8-16 weeks
Throughout
Throughout
Throughout
8-12 weeks
Throughout
Months to years
Evaluation of the efficacy of cysteamine 5% cream in the treatment of epidermal melasma: a randomized double-blind placebo-controlled trial.
Br J Dermatol (2015) · Rct · n=50
First double-blind placebo-controlled RCT of cysteamine 5% cream for epidermal melasma (n=50), nightly for 4 months
Efficacy of cysteamine cream in the treatment of epidermal melasma, evaluating by Dermacatch as a new measurement method: a randomized double blind placebo controlled study.
J Dermatolog Treat (2018) · Rct · n=40
Second double-blind placebo-controlled RCT (n=40), nightly cysteamine 5% for 4 months, with Dermacatch and Mexameter colorimetry
A comparative study of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women.
Int J Dermatol (2020) · Rct · n=40
Multicenter evaluator-blinded head-to-head of cysteamine 5% vs hydroquinone 4% (n=40), nightly for 120 days with sunscreen
Efficacy and safety of a new triple-combination agent for the treatment of facial melasma.
Cutis (2003) · Rct · n=641
Two pooled 8-week multicenter randomized investigator-blind trials (n=641) of the triple-combination (tretinoin 0.05% + hydroquinone 4% + fluocinolone 0.01%) vs the three dual pairings
Efficacy and safety of a novel triple combination cream compared to Kligman's trio for melasma: A 24-week double-blind prospective randomized controlled trial.
J Eur Acad Dermatol Venereol (2023) · Rct · n=40
24-week double-blind RCT (n=40) using Kligman's trio (hydroquinone + retinoic acid + corticosteroid) as the active gold-standard comparator
Systematic review of randomized controlled trials on interventions for melasma: an abridged Cochrane review.
J Am Acad Dermatol (2014) · Systematic review
Abridged Cochrane review of 20 RCTs (2125 participants) across 23 melasma treatments
Hydroquinone has a higher evidence score (7/10 vs 6/10) and wins in 2 of 3 categories.
For even skin tone, Hydroquinone has a higher relevance score (85 vs 70).
No known interactions between Cysteamine (topical) and Hydroquinone have been documented in our database. However, always consult a healthcare provider before combining supplements.