• Hydroquinone is a hydroxyphenolic compound that has been widely used for skin lightening for 50 years. It is the only FDA approved product for bleaching and a prescription is required to obtain products with a concentration above 2%.

    Hydroquinone is arguably the most effective ingredient in treating hyperpigmentation, and is a favorite among many dermatologists and patients suffering from pigmentation disorders. Hydroquinone decreases the production and the increases the breakdown of melanin in the skin. Despite its proven success, hydroquinone is not without controversy. There have been various studies done showing the possible side effects and risks of hydroquinone use. In 2006 the FDA questioned the safety of hydroquinone as a GRASE (generally recognized as safe and effective) product, and continued testing of the safety of this drug is currently ongoing.

    The weight of the benefits versus the risks of this drug is an ongoing debate within the medical community. Understanding the information on both sides of this issue is crucial before deciding to begin a skin care regimen including hydroquinone.

    The Debate

    Hydroquinone is considered by some to be unrivaled in its treatment of hyperpigmentation and other pigmentation problems. There is no doubt of it’s usefulness in this aspect. Results from hydroquinone treatments generally far surpass those of hydroquinone alternatives.

    Many dermatologists, including Dr. Susan Taylor, founding director of the Skin of Color Center in New York City, stress the considerable benefits of this drug over risks that some doctors consider questionable.

    Some skin problems are far greater than the average person can understand, and can only be effectively treated with hydroquinone. As Dr. Fran Cook-Bolden says, “My associates and I really do see the devastating effects of hyperpigmentation on our patients, from their ability to acquire employment and to succeed professionally, to the effect on successful personal and social relationships.” Drastic treatments are needed in cases such as these.

    Potential Side Effects

    Detractors of hydroquinone point out that it has been shown as a carcinogen (cancer-causing) in studies done on rodents that were given this drug orally. As reported by Dermatology Times, Dr. Susan Taylor said, “If you give a rat enough of anything orally it may well develop cancer.” Proponents are quick to point out that an oral administration of a drug can produce different effects than a topical application. Studies for drugs that have been shown to cause cancer in rodents do not always produce similar effects in humans.

    Ochronosis

    Ochronosis is a skin disorder that is characterized mainly by skin that becomes darker and thick, the result of long-term build up of phenylalanine or tyrosine. The use of hydroquinone has been linked to cases of Ochronosis, particularly in South African women who used high concentrations over very large surface areas. In America, hydroquinone is generally used in much lower doses and on smaller areas of the skin, thereby reducing the possibility of the occurrence of ochronosis.

    Other studies have shown that abnormal adrenal gland function and high mercury levels are among the side effects of hydroquinone use, however neither of these findings was present as reasons in the FDA’s proposed ban on hydroquinone.

    Some people point to the fact that this drug is banned in various countries such as Japan and Australia, as well as in the European Union, as evidence of its danger. There are however, certain substances and drugs banned in the US for potential carcinogen effects which are legal in many other countries. Standards for various industries across the world can be quite different, and a ban in one country is not necessarily the final word on the safety of a particular item.

    Given there exists such a plethora of varying data, it is important for customers to understand the potential risks of hydroquinone, and weigh those risks against their particular skin care needs. Discuss your concerns and needs with a dermatologist in order to obtain the best information and advice regarding your hyperpigmentation and pigmentation disorders.