A compounded triple-combination cream for melasma and uneven pigment — tretinoin 0.1%, hydrocortisone 1% and hydroquinone 4%, or 8% in Max for stubborn patches — prescribed online, reviewed by licensed providers, prepared by a U.S. 503A pharmacy and shipped discreetly to every state except Alabama, Arkansas, California, Florida, Kentucky and South Carolina.
$417 for 3 months
Choose your formula
The usual starting strength.
Supply
One payment for a 3-month supply.
A few private questions, then a licensed provider reviews your answers.
The formula
A compounded prescription cream
This is a triple-combination cream: three prescription actives in one base, the approach dermatologists have used for decades for melasma. Ours is compounded by a U.S. 503A pharmacy; compounded formulas are not themselves FDA-approved.
Hydroquinone (4%, or 8% in Max) slows the production of new pigment, tretinoin 0.1% speeds the turnover of pigmented cells and helps the hydroquinone reach where it works, and hydrocortisone 1% calms the irritation the other two can cause.
Through ForbiddenRx, a licensed provider reviews your skin and history and decides whether this cream, and how it is used, is right for you.
Melasma is a pigment condition: pigment cells in the skin become overactive and deposit brown or grey-brown patches, most often on the cheeks, forehead, upper lip and chin. Sunlight, visible light, heat and hormones (pregnancy, birth control) are common triggers, which is why it tends to return without daily sun protection and why it usually needs a prescription-strength approach.
Melanocytes produce more pigment than surrounding skin, creating patches. Hydroquinone slows that production.
Sun, visible light and hormonal changes restart the process, so daily broad-spectrum SPF is part of every melasma plan.
Over-the-counter brightening products use milder ingredients at fixed strengths. Since 2020, hydroquinone is prescription-only in the U.S., and this cream pairs it with tretinoin and a mild steroid, with a provider deciding whether it fits your skin.
| Brightening serum (OTC) | Single-active Rx cream | Melasma Cream (Rx) | |
|---|---|---|---|
| What it is | Vitamin C, niacinamide or similar | One prescription active | Three prescription actives |
| Hydroquinone | No (Rx-only since 2020) | Sometimes | Yes, 4% or 8% |
| Provider involved | No | Yes | Yes — reviews your skin & history |
| Formula | One-size-fits-all | Fixed | Compounded per prescription |
Melasma is stubborn and tends to return. A provider decides whether a triple cream is right for you and how it fits with sun protection and maintenance.
Each active works on a different part of the pigment problem, which is why the three are combined.
Hydroquinone (4%, or 8% in Max) reduces the activity of tyrosinase, the enzyme pigment cells use to make melanin.
Tretinoin 0.1% speeds how quickly pigmented surface cells shed and helps the other actives penetrate.
Hydrocortisone 1%, a mild steroid, settles the redness and irritation the other two can cause.
It's for adults with melasma or stubborn dark patches. A provider confirms it's appropriate for your skin and history.
Brown or grey-brown patches on the cheeks, forehead, upper lip or chin.
Pigment that over-the-counter brighteners haven't improved.
Darker marks left after acne or irritation, when a provider thinks it fits.
Patchy pigment you'd like to even out under a provider-guided plan.
Avoid it if you're pregnant, trying to conceive or breastfeeding. Hydroquinone used for long periods or at high strength can cause ochronosis (a blue-black darkening of the skin), so it is used under a provider's plan, not indefinitely. Tell your provider about broken or irritated skin, eczema, or a past reaction to any of the three actives.
You complete a private online visit, a licensed provider reviews it, and — if appropriate — your prescription ships to your door. No insurance required, no in-person appointment, no waiting room.
A few private questions about your skin, goals, and history, on your own time.
A provider licensed in your state reviews your information and, if appropriate, writes your prescription.
Shipped from a U.S. pharmacy in plain, unmarked packaging to every state except Alabama, Arkansas, California, Florida, Kentucky and South Carolina. Reorder anytime from your dashboard, and our support team is an email or call away.
Your price is shown before you pay. No insurance needed.
This is a compounded topical. How much you use, how often, and for how long are set by the provider who reviews your visit. We deliberately do not publish a regimen here, because that is a clinical decision about you, not a product specification.
Do not use it if you are pregnant, planning to become pregnant, or breastfeeding. Tell your provider about pregnancy, all medications and any skin conditions before starting.
Possible side effects include:
Stop and contact your provider if you develop severe irritation, blistering, a rash, or any darkening of the treated skin.
A side-by-side look at the prescription skin options available through ForbiddenRx. Your provider helps you choose what's right.
| Treatment | What it is | Best for | Form | For | Rx required |
|---|---|---|---|---|---|
| Tretinoin | A prescription retinoid (vitamin A) | Acne + anti-aging | Cream / gel | Adults | Yes |
| Melasma Cream This page | Tretinoin / hydrocortisone / hydroquinone 4% or 8% | Melasma & dark patches | Cream | Adults | Yes |
| Luminous Gel | Kojic / tranexamic acid / tretinoin | Melasma, hydroquinone-free | Gel | Adults | Yes |
| Clarity Cream | Clindamycin / spironolactone / tretinoin | Acne | Cream | Adults | Yes |
| Rosacea Cream | Azelaic acid / ivermectin / metronidazole | Rosacea | Cream | Adults | Yes |
| Anti-Aging Night Cream | Estriol / tretinoin / vitamin C | Fine lines & firmness | Night cream | Adults | Yes |
| Under-Eye Cream | Caffeine / tretinoin / glycolic acid | Dark circles & puffiness | Eye cream | Adults | Yes |
| Scar Gel | Silicone / betamethasone / lidocaine | Raised scars | Gel cream | Adults | Yes |
| GHK-Cu Cream | A copper-peptide repair cream | Firmness & recovery | Cream | Adults | Yes |
It combines hydroquinone (4%, or 8% in Max), which slows new pigment, tretinoin 0.1%, which speeds the turnover of pigmented cells, and hydrocortisone 1%, which calms irritation. Together they are a long-used approach to melasma and stubborn dark patches.
Pigment fades slowly. Many people notice changes over several weeks to a few months of consistent use with daily sun protection. Results vary, and melasma can return, which is why your provider plans maintenance.
The same cream with hydroquinone 8% instead of 4%, for stubborn patches. Most people start on 4%. A higher strength can irritate more, so your provider decides whether Max fits and how long to use it.
Since 2020, hydroquinone is no longer sold over the counter in the U.S. At prescription strength it should be used under a provider's plan, including how long to use it, because long or high-strength use can cause side effects.
Yes. Luminous Gel uses kojic acid, tranexamic acid and tretinoin instead. Your provider can help you choose.
Yes — every day. Sunlight and visible light restart melasma, and tretinoin increases sun sensitivity. A broad-spectrum SPF is part of the treatment.
No. It should be avoided during pregnancy, while trying to conceive, and while breastfeeding. Tell your provider if any of these apply.
Physicians, NPs & PAs licensed in your state
U.S.-based compounding partners
We confirm your state during intake
Complete a private online visit and a licensed provider decides whether melasma cream is right for you, and how to use it.
Written by ForbiddenRx and checked against FDA prescribing information and published sources · Updated October 2026. It is general information, not a review of your own health; your provider decides what is right for you. It is provided for general educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk with a licensed provider about your individual skin and health.
This page is educational and is not medical advice.