Cream
Acne Cream
Triple-action topical for acne: antibiotic (clindamycin + erythromycin) and antifungal (ketoconazole). Covers bacterial and fungal acne.
Starting at $101/mo
MelasmaDark spotsShort course
Brightening Cream
RxPrescription onlyApplied to the skin · Once a day · Melasma · Dark spots · Short course
Starting at $109/mo
A stronger prescription cream for stubborn melasma and dark spots: hydroquinone 6% with tretinoin, a low-strength hydrocortisone, kojic acid and vitamins C and E. Applied once at bedtime for a short course, usually up to 8 weeks.
Choose your plan
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- A triple-action formula that fades stubborn pigment faster than hydroquinone alone
- Tretinoin speeds skin renewal; hydrocortisone calms the irritation
- A short course of about 8 weeks, then your physician plans maintenance
Every plan includes
- Personalized, physician-guided plan
- Monthly, 3-month and 6-month plans
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is Brightening Cream?
(hydroquinone 6% + tretinoin + hydrocortisone + kojic acid + vitamins C and E)
It follows the logic of the classic triple combination dermatologists use for melasma: hydroquinone and kojic acid slow melanin production, tretinoin speeds up skin renewal so pigmented cells shed faster, and a mild corticosteroid calms the irritation the other two can cause. Vitamins C and E add antioxidant support. Because of the tretinoin and the steroid, it is meant for a short course, not for continuous use.
- How it is taken
- Applied to the skin
- How often
- Once a day
- Form
- Melasma · Dark spots · Short course
8 weeks
the usual course for a triple-combination cream
The FDA-approved triple combination for melasma is labeled for up to 8 weeks. Melasma often returns after stopping, so daily sunscreen and a gentler maintenance plan matter.
How it works,
week by week.
Week 1
A physician reviews your skin, your spots and your health, and chooses the formula and how long to use it. You test the cream on a small area first.
Weeks 2–4
Some redness, dryness or peeling is common while the skin adjusts. Daily sunscreen starts now and does not stop.
Weeks 4–8
Spots begin to fade. Brightening Cream usually completes its short course around week 8.
Months 2–4
Hydroquinone courses usually end by 3 to 4 months, followed by a break and a gentler maintenance plan your physician sets.
What you may notice,
and when.
Daily SPF is part of the treatment
without it, spots return and can get darker
Gradual fading
most people see change after 4 to 8 weeks
Used in courses
breaks between courses lower the risk of ochronosis
More even tone
a maintenance plan keeps results after the course
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
These creams contain hydroquinone and are prescription treatments. Do not use them if you are pregnant, trying to become pregnant or breastfeeding; Brightening Cream also contains tretinoin, which must not be used in pregnancy. Do not use them if you are allergic to hydroquinone or sulfites, and tell your physician if you have asthma. Apply only to the dark spots, never on broken or irritated skin, and keep away from the eyes and lips. Use a broad-spectrum SPF 30+ every day. Hydroquinone is used in courses with breaks: with long continuous use it can rarely cause ochronosis, a blue-black darkening of the skin. If the treated skin gets darker instead of lighter, stop and contact your physician. Do not use peroxide products such as benzoyl peroxide on the same area. A new or changing mole or spot needs an in-person check, not a brightening cream.
The research behind
skin brighteners.
These creams mix several actives. Azelaic acid, niacinamide, tranexamic acid, vitamin C and hydroquinone have the most human data for dark spots; the rest have little or none.
- Azelaic acidMASI -1.23 vs hydroquinone
Meta-analysis of six randomized trials with 673 people with melasma: azelaic acid lowered the melasma severity score more than hydroquinone (mean difference -1.23, 95% CI -2.05 to -0.40). The trials used 20% azelaic acid; the creams here contain 10%.
Albzea et al., Cureus 2023;15(7):e41796 - Niacinamidereduced spots vs vehicle
A moisturizer with 5% niacinamide was tested in 18 women with hyperpigmentation in a paired design. After 4 weeks, hyperpigmentation fell and skin lightness rose compared with vehicle. The 35–68% figure is from a laboratory model, not a skin result.
Hakozaki et al., Br J Dermatol 2002;147(1):20-31 - Tranexamic acid22 studies, 1,280 patients
A 2024 meta-analysis found tranexamic acid significantly reduced melasma severity, with oral use showing the largest drop; studies were highly heterogeneous. A 2019 systematic review rated it a strong recommendation.
Calacattawi et al., J Dermatolog Treat 2024; Austin et al., J Drugs Dermatol 2019
What the studies found
- Azelaic acid lowered the melasma severity score more than hydroquinone in pooled trials (mean difference -1.23 MASI; Albzea et al., Cureus 2023).
- In a paired study of 18 women, 5% niacinamide lightened hyperpigmentation vs vehicle after 4 weeks (Hakozaki et al., Br J Dermatol 2002).
- Tranexamic acid significantly reduced melasma severity across 22 studies with 1,280 patients (Calacattawi et al., J Dermatolog Treat 2024).
- A six-month trial of 5% vitamin C cream showed clinically apparent improvement in photoaged skin vs vehicle (Humbert et al., Exp Dermatol 2003).
Each cream's actives are at the strength on its label. Trial results are for the single active at the strength studied, not for the mixture. The hydroquinone creams (brightening cream and ClearTone) are prescription drugs; compounded versions were not studied.
What this does not say
- Vitamin C has a six-month double-blind trial of 5% vitamin C cream against vehicle in photoaged neck and arm skin, which reported clinically apparent improvement and a smoother skin relief (Humbert et al., Exp Dermatol 2003). It is not a melasma trial.
- We found no melasma outcome trial for hyaluronic acid, caffeine, dexpanthenol, vitamin E or resveratrol in these creams; they hydrate or support.
- Clindamycin, erythromycin and ketoconazole in the acne creams have evidence in acne, not in brightening.
- Hydroquinone carries a theoretical risk of ochronosis with long use.
The research
behind it.
In clinical trials, triple-combination creams (hydroquinone, tretinoin and a corticosteroid) cleared or nearly cleared melasma in more patients than any of their ingredients alone.
The trade-off is irritation and sun sensitivity: redness, peeling and dryness are common in the first weeks, and tretinoin and hydroquinone must not be used during pregnancy.
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I use Brightening Cream?
Applied to the skin, once a day, at bedtime. The starting prescription is 1 mL each time. Your physician sets your own dose and it is printed on your label.
What exactly is in it?
Ascorbic Acid, Hydrocortisone, Hydroquinone, Kojic Acid, Tretinoin, Vitamin E.
How much arrives in each shipment?
1 tube at the starting strength, shipped to your door from a licensed US pharmacy.
Why only a short course?
The tretinoin and the corticosteroid make it strong. Used longer than prescribed, the steroid can thin the skin and the irritation adds up. Your physician uses it to get the spots under control and then moves you to a gentler plan.
Which brightening cream is right for me?
GHK-Cu Brightening Cream (hydroquinone 6% with niacinamide) is the usual first choice: gentler, for melasma, sun spots and acne marks, in courses of 3 to 4 months. Brightening Cream adds tretinoin and a mild steroid: stronger and faster, for stubborn melasma, but more irritating and only for up to 8 weeks; it is not for eczema, rosacea or pregnancy. ClearTone uses a lower hydroquinone strength (4%) with azelaic and tranexamic acids. If you are not sure, choose GHK-Cu Brightening Cream: your physician confirms the right one or switches you.
Can I use it while pregnant or breastfeeding?
No. Hydroquinone is avoided in pregnancy and breastfeeding, and the tretinoin in Brightening Cream must not be used in pregnancy. Tell your physician right away if you become pregnant.
Do I really need sunscreen every day?
Yes. Sun exposure triggers new pigment and undoes the treatment. Use a broad-spectrum SPF 30 or higher every morning, reapply outdoors, and add a hat in strong sun.
What if my skin gets darker?
Irritation can make spots look darker for a short time. If the treated skin keeps darkening or turns gray or blue-black, stop the cream and message your physician: with long use, hydroquinone can rarely cause ochronosis.
Brightening Cream educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
More options
in this area.
Cream
Acne Cream with Tretinoin
Acne treatment combining antibiotics (clindamycin/erythromycin/ketoconazole) with tretinoin for faster clearance and post-acne healing.
Starting at $101/mo
Cream
Clarity Cream
Acne and post-acne formula combining azelaic acid, niacinamide, clindamycin, and tretinoin. Anti-inflammatory and cell-renewing.
Starting at $109/mo
Cream
ClearTone Cream
Brightening and anti-inflammatory cream combining azelaic acid, hydroquinone, kojic acid, tranexamic acid, and niacinamide. For post-acne hyperpigmentation.
Starting at $109/mo
References
- 1.Hydroquinone prescribing information: depigmentation, sulfites, ochronosis and use in pregnancy. US prescribing labels (DailyMed)
- 2.Fluocinolone, hydroquinone and tretinoin cream for melasma: indicated for up to 8 weeks. Tri-Luma prescribing information (DailyMed)
- 3.Topical tranexamic acid and azelaic acid in melasma. PubMed
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.