By Dr. Roshini Raj

My sun spots are out of control. Are those fading creams safe?

The reason the creams are controversial is that some of them contain hydroquinone. Though it’s the gold standard for nixing sun spots, hydroquinone was banned in some countries after animal studies suggested that it was a possible carcinogen. But note: The animals used in the studies ate large amounts of the chemical over long periods of time—which is not at all the way you would use it. Still, the FDA has asked for more studies in order to make sure it’s safe to keep on the market.

In the meantime, you can get a hydroquinone lotion over the counter or by prescription. It’s safe to do so as long as you follow some guidelines. First, don’t apply the cream more than twice a day for more than six months without consulting your dermatologist, even if you get it at the drugstore. Though the condition is pretty rare, prolonged use of hydroquinone may cause ochronosis, which leads to skin thickening and discoloration.

In some people, hydroquinone creams may also cause some irritation, so it’s a good idea to test the cream on a small patch of skin first and follow all instructions on the label. Depending on the specific cream, the package instructions may suggest, say, applying it twice a week at first before increasing to daily use.

Products with retinol (the active ingredient in many anti-aging products) can also help erase sun spots. So if you’re using retinol on your face, you may already have something in your medicine cabinet that should help. Keep in mind that hydroquinone needs to be used with SPF 30 because it can heighten sun sensitivity. Pregnant? Skip hydroquinone and retinol for now.

Health’s medical editor, Roshini Rajapaksa, MD, is assistant professor of medicine at the NYU School of Medicine.

Meet Dr. Raj at the Health Total Wellness Weekend at Canyon Ranch in May 2015. For details, go to Health.com/TotalWellness.

Originally published on Health.com