Hydroquinone works, but used for too long it can leave patients with worse pigment than they started with. In this episode of The Practice Lab, Tracey Mancuso talks with ingredient expert Marie Bertrand about when hydroquinone still makes sense, how to use it safely, and what to use instead for long-term pigment control.

In this episode:

Why hydroquinone is still a gold standard, and what Health Canada's 2% over-the-counter limit means

Pulse therapy: two to three months on, then switch

Marie's four steps to pigment control: exfoliation, pigment reduction, anti-inflammatory care and a tinted mineral sunscreen

Why some pigment is really vascular, and why treating it as pigment never works

Azelaic acid, the multitasker for redness, PIH and sensitive skin

How to talk patients off long-term hydroquinone without scaring them

Epidermal vs dermal pigment, and prepping the skin before lasers and microneedling

Tretinoin, the Kligman formula, and why the skin barrier comes first

As Marie puts it: "Hydroquinone should be seen as a sprint and not a marathon." And on prepping the skin: "We cannot exfoliate our way to a dermal pigment."

Learn more: Marie's introduction to ingredients is on The DermaRoom Collective at thedermaroomcollective.com. Her full ingredient masterclass is coming in early 2027.

About the guest: Marie Bertrand is a microbiologist and the founder of SkinScience Clinic in Calgary. Reach her at info@skinscience.md or on Instagram at @theskinscientist, and read her blog at skinscience.md.

About the host: Tracey Mancuso, BScHS, CMLSO, is the founder and course director of The DermaRoom Collective. A Certified Medical Laser Safety Officer with more than 30 years in aesthetic medicine, she teaches laser, light and RF treatment to practitioners.