If you have obstinate discoloration or post-inflammatory darkening, you've definitely come across some hydroquinone-related advice (online or otherwise). However, few cosmetics compounds are as contentious as this topical skin-lightening agent. Hydroquinone is not approved in the European Union, Japan, or Australia. 

Is it truly safe? How did it receive such a terrible reputation after getting FDA approved?

 

Source: WebMD.com

 

What is Hydroquinone?

Hydroquinone is a crystalline chemical that is utilized in skin care as a depigmentation of skin-lightening agent. It aids in the lightening of darker skin regions such as hyperpigmentation, freckles, age spots, and melasma caused by acne, hormone changes, or skin damage.

In other words, Hydroquinone is a skin lightener. This bleaches the skin, which can be beneficial when treating various types of hyperpigmentation. It lightens your skin by reducing the number of melanocytes. Melanocytes produce melanin, which is responsible for your skin's color.

Brand Names

According to Pharmacist, John Cunha, hydroquinone is available under the following different brand names: Lustra, Melquin, Melquin HP 4%, Melquin-3 Topical Solution, Lustra-AF, Lustra-Ultra, Alphaquin, Claripel, Clarite, Eldopaque, Eldoquin, Epiquin Micro, Esoterica, Melanex, Melpaque, Nuquin HP Cream, Nuquin HP Gel, and Solaquin.

Dosages in Products

Topical cream	Lotion	Emulsion	Topical Solution	Topical Gel
2% 4%	2%	4%	2% 3%	2% 4%

Source: Medical and Pharmacy Editor: John P. Cunha, DO, FACOEP

 

The Common Uses

Hydroquinone stops existing dark spots from becoming darker and causes them to diminish gradually by inhibiting the skin's generation of melanin. Hydroquinone doesn't really lighten the skin irreversibly. Despite this, it is still regarded the go-to spot lightener in the United States, with many doctors recommending hydroquinone to:

• Treat every form of hyperpigmentation, from post-inflammatory hyperpigmentation caused by acne to aging and sun spots.
• Melasma, which appears as spots of darker skin on the forehead, cheeks, and upper lip, can be faded.
• To get a more balanced complexion, brighten darker parts of skin.
• scars from acne
• aging spots
• freckles
• psoriasis and eczema post-inflammatory markings

 

Source: Skinkraft

How to Use Hydroquinone

This drug should be applied to the afflicted regions of skin twice a day, or as instructed by your doctor. This drug should only be applied to the skin. Unwanted skin whitening may result if it is used inappropriately. You should avoid getting this product in your eyes, nose, or mouth. If you acquire this medicine in such locations, rinse well with water.

 

Follow all product instructions or use as advised by your doctor. This drug may increase the sensitivity of the treated skin to the sun. Avoid extended exposure to the sun, tanning salons, and sunlamps. When going outside, use sunscreen and wear protective clothes on the treated regions of skin.

 

Apply a tiny dose of this drug to an unbroken skin region before usage, and inspect the area within 24 hours for any major adverse effects. If the test area becomes itchy, red, swollen, or blistered, discontinue usage and consult your doctor. Treatment with this product can begin if there is just minimal redness.

 

Side Effects

Mild burning, stinging, redness, and dryness are common adverse effects of hydroquinone. Inform your doctor or pharmacist right once if any of these side effects continue or worsen.

 

Stop taking hydroquinone immediately and notify your doctor if any of the following unlikely but significant adverse effects occur: blistering, skin breaking, blue-black skin discoloration.

 

It is uncommon for this medicine to cause a severe allergic response. However, get emergency medical assistance if you detect any of the following signs of a severe allergic reaction: rash, itching/swelling (particularly of the face/tongue/throat), extreme dizziness, and difficulty breathing.

 

This is not an exhaustive list of potential negative effects. Contact your doctor or pharmacist if you experience any other side effects not listed above.

 

 

Why the Long- Term Use of Hydroquinone is Not Advisable

 

Even though hydroquinone can help eliminate lingering red or brown stains, it will not assist with ongoing inflammation. The chemical, for example, can help reduce acne scars but has little effect on redness from current outbreaks.

 

When you are using hydroquinone at a high concentration or for an extended period of time, ochronosis can cause the skin to darken even more, which is the inverse of its intended usage – to remove black spots. When paired with sun exposure, hydroquinone can cause dryness, redness, and heightened sensitivity. Although several research investigations indicated that it was a carcinogen, it has not been conclusively confirmed to cause cancer.

 

Although hydroquinone can be an effective therapy for undesirable pigmentation, it is occasionally used at harmful, uncontrolled amounts in skin bleaching creams. To enhance the effects of hydroquinone, several black-market bleaching lotions mix it with hazardous chemicals like mercury. Fortunately, owing to the #melanin movement and dark-skinned celebrities and influencers, many women are opposing colorism and rejecting all that bleaching creams symbolize.

 

On average, the component takes four weeks to take effect. It may take many months of constant use to experience the full benefits. Even if you've never noticed any improvement after three months of OTC usage, consult a dermatologist. They may be able to offer a prescription-strength solution that is more appropriate for your requirements.

 

Hydroquinone may be useful for no more than five to six months. When you discontinue use, you may notice discomfort in the affected areas of your body. This may result in inflammation. This inflammation can be problematic since your skin develops resistance to the therapy after a specific period of time.

 

There is no evidence that topical treatment of hydroquinone on the skin increases the risk of cancer forming. However, long-term usage might cause the uppermost layer of skin to thin. This may raise the chances of developing skin cancer or causing skin harm. Even extremely high amounts of hydroquinone can cause skin cancer.

 

Why You Should Consult a Dermatologist First

 

Inquire with your doctor about how long you should take hydroquinone topical. The amount of time you use this drug will vary depending on the product, the company, and your condition. However, if you don't see any improvement in your dark spots after 2 months of using hydroquinone topical, you should stop using it. Please consider alternative treatment options with your dermatologist or healthcare professional if necessary.

 

Hydroquinone topical was previously accessible without a prescription (OTC). However, due to the 2020 CARES Act, it is only available with a prescription from your provider. This medication was removed from the OTC market because the FDA had some concerns about its safety and there wasn't enough research provided in a timely manner.

It has caused safety concerns among youngsters and pregnant women who have used it. This drug is appropriate for children above the age of 12. However, use in children aged 12 and under should be avoided because there hasn't been enough research on the medication's safety in this age range.

 

 "You should absolutely not take hydroquinone when pregnant or breastfeeding," advises Robinson. It is advised to stop using hydroquinone before becoming pregnant. Hydroquinone has been linked to fetal damage in animal reproduction research. Given that a higher dose is more effective in humans, it is best to discontinue use of hydroquinone the day your pregnancy test is positive. You may also visit our medical specialists to learn more about the details. This contentious synthetic pigment reduction is accessible in the United States but is prohibited in Europe, Japan, and Australia because it is a carcinogenic, cancer-causing chemical. The FDA has voiced worry about the chemical and has stated that additional research on its safety is required. Until then, it is advisable to avoid using hydroquinone when pregnant or nursing.

 

Hydroquinone on Dark Skin

 

Hydroquinone is generally considered safe. However, if you have dry or sensitive skin, you may experience further dryness or irritation. According to Yashoda Hospital, applying hydroquinone lotion to dark skin might exacerbate hyperpigmentation. Furthermore, this chemical contains inactive components such as sulfites, which help to reduce allergic responses. If you have asthma or skin conditions such as eczema or psoriasis, you should seek medical guidance. Hydroquinone is generally considered safe. However, if you have dry or sensitive skin, you may experience further dryness or irritation. Applying hydroquinone lotion to dark skin might exacerbate hyperpigmentation. Furthermore, this chemical contains inactive components such as sulfites, which help to reduce allergic responses. If you already have asthma or skin issues, you should seek medical assistance.

 

Other Healthier Alternatives

 

• Antioxidants

Vitamins A and C are often utilized in anti-aging treatments to brighten the skin and enhance your overall tone. When utilized over time, antioxidants may also help brighten spots of hyperpigmentation.

 

• Acids derived from plants

Acids, contrary to common assumption, are not usually chemically based. Many acids used in skincare products are produced from plants. For hyperpigmentation, you could try kojic or ellagic acids. These function by slowing down your skin’s melanin production.

 

Kojic acid is a chemical generated from a fungus that looks like a mushroom. Like hydroquinone, it inhibits and prevents the formation of tyrosine, but is a gentler alternative. Kojic acid can be found in serums, treatments, and lotions. Anyone with sensitive skin, on the other hand, may experience redness and irritation, so be sure to patch test beforehand.

 

Azelaic acid is a well-known hydroquinone substitute for post-inflammatory hyperpigmentation. This mild ingredient is great for acne-prone skin, acting as a leave-on exfoliator to reduce inflammation, eliminate pigmented cells, and expose a more even skin tone. Azelaic acid can be found in spot treatments, face cleansers, and toners.

 

• Vitamin B3

Niacinamide, or vitamin B3, does not prevent melanin formation, but rather diminishes the amount of melanin that is transported to the skin's surface. Niacinamide lightens dark spots over time by preventing pigment migration. Long-term niacinamide administration can also aid in the healing and reduction of inflammatory pimples like papules and pustules.

 

 

Pros	Cons
● Available as a lower-cost generic medication ● Available in multiple dosage strengths and forms ● Available as a combination product with sunscreen to protect your skin	● Not safe to use in children 12 years or younger ● Can cause skin dryness, redness, and stinging ● Can cause blue-black skin discoloration, especially in black people ● Must use sunscreen because exposure to sunlight can reverse effects of the medication

 

Tips From Experts

 

Hydroquinone topical is available in a variety of formulations and products. If your provider instructs you to follow the instructions on the package, please be aware that the instructions may vary depending on the brand or product. Hydroquinone topical should only be applied to the skin's outer layer. Avoid putting the drug in or near your eyes, nose, mouth, or lips, as this might cause irritation.

 

Some persons may experience an adverse response to hydroquinone topical. If you're using this medication for the first time, test your skin by putting a little quantity to a non-damaged or broken region of your skin. Wait one day to see whether you get a skin reaction like itching, blisters, or a rash. You can use this medicine if you don't have a response or simply have moderate redness. If you experience an allergic response, contact your doctor immediately and avoid using hydroquinone topical.

 

Hydroquinone topical should be kept at room temperature and out of the reach of children at all times. If your medication's seal is missing, cracked, or damaged, do not use it since it may have been tampered with. If you are concerned about the packaging of your product, notify your pharmacist immediately.

 

Works Cited

Cunha, John P. “Hydroquinone: Generic, Uses, Side Effects, Dosages, Interactions, Warnings.” RxList, 2021, https://www.rxlist.com/consumer_hydroquinone_melquin_3/drugs-condition.htm. Accessed 23 June 2022.

Good Rx. “Hydroquinone topical: Basics, Side Effects & Reviews.” GoodRx, 22 February 2022, https://www.goodrx.com/hydroquinone/what-is. Accessed 23 June 2022.

Hayes, Estera. “Hydroquinone in Skin Care: Magical Brightener or Dangerous Lightener?” Hero Cosmetics, 29 July 2020, https://www.herocosmetics.us/blogs/news/hydroquinone-in-skin-care-magical-brightener-or-dangerous-lightener. Accessed 23 June 2022.

Healthline. “Hydroquinone: Uses, Safety, Side Effects, OTC Products, Alternatives.” Healthline, 2018, https://www.healthline.com/health/beauty-skin-care/hydroquinone#takeaway. Accessed 23 June 2022.

Yashoda Hospital. “Hydroquinone - Side Effects, Dosage, Precautions, Uses.” Yashoda Hospitals, 2021, https://www.yashodahospitals.com/medicine-faqs/hydroquinone/. Accessed 23 June 2022.