You can actually by hydroquinone over the counter without a prescription at CVS, Walgreens, etc., but only the 2% strength is available. Prescription strength starts at 4%. Some doctors find a combination of medications to be more effective at lightening skin. Hydroquinone can be combined with kojic acid, tretinoin, and hydrocortisone to improve lightening efficacy. This is created at a compounding pharmacy where potency and ingredients can be varied as directed by your doctor. Usually a dermatologist or plastic surgeon will prescribe this formula. It may also be available in prescription retail products such as those provided by Obagi. Good luck!!