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5 Little Known-Facts Every Hydroquinone User Needs to Know - Immediately!

hydroquinone

Recently, my friend Jessica over at Out in a Pout wanted to know the potential side effects of discontinuing use of hydroquinone. Now, Jessica's a beauty expert herself, so her question really made me ponder just how much the public knows about hydroquinone. So I started avidly researching the topic. Turns out there is so much to know. There are certain amounts of time you should use hydroquinone, there are certain products and ingredients you shouldn't use with hydroquinone (like benzoyl peroxide and resorcinol), you shouldn't get hydroquinone in your eyes, and you shouldn't worry about hydroquinone and cancer. Read more to find out about these:

1.) Hydroquinone should be used in four-month cycles, alternating with kojic acid, azelaic acid, arbutin, and other lightening agents. (Especially if you have darker skin.)

kojic_acid

Hydroquinone works by inhibiting the enzyme tyrosinase, which is important in skin melanin (pigment) development. So for as long as you continue to use hydroquinone, you will inhibit tyrosinase, and hence pigment production. Unfortunately, when you discontinue use of hydroquinone, your skin's natural supply of tyrosinase will no longer be inhibited. Slowly but surely, your skin's natural pigmentation will return.

If you're thinking that you should never stop using hydroquinone, think again: In darker skinned patients, continued hydroquinone use has been associated with ochronosis, a darkening of the skin. It has been proposed this occurs because hydroquinone inhibits homogentisic acid oxidase within the skin, which in turn causes the dark-colored homogentisic acid to build-up within the skin with continued use. Interestingly enough, this phenomenonhas only been documented in darker-skinned patients.

Still, to be on the safe side, most dermatologists recommend using hydroquinone in four-month cycles, alternated in the off months with other milder tyrosinase inhibitors, such as azelaic acid, kojic acid, and arbutin. I personally recommend Cape Fear Naturals Kojic Acid Cream Skin Brightener ($11.95, amazon.com) with 4% kojic acid, the highest concentration available on the U.S. market without a prescription. To be frank, the packaging could use a makeover and the retinol is rendered virtually worthless with full air exposure in the open-top jar container, but the truth of the matter is, no product on the market contains more kojic acid for a lower price. It also works great when alternated for four months with hydroquinone, as mentioned above.

[Read More: Which is Better: Kojic Acid or Hydroquinone?]

2.) Do NOT use any other products containing benzoyl peroxide while you are using products containing hydroquinone. 

hydroquinone_and_benzyol_peroxide

Use of hydroquinone with any products containing benzoyl peroxide, hydrogen peroxide, or other peroxides may cause temporary staining of the skin (Drugs.com). This staining is temporary and can typically be removed with soap and water washing, but it's best to avoid benzoyl peroxide-based acne treatments and oxygen-infusing skin care treatments, which typically contain hydrogen peroxide.

3.) Do NOT use any products containing resorcinol while you are using products containing hydroquinone. 

resorcinol_and_hydroquinone

Remember that skin darkening I was talking about earlier (ochronosis)? Unfortunately, ochronosis occurrence in people with darker skin combing resorcinol and hydroquinone is well-documented. Hundreds of ochronosis cases have been documented from using resorcinol/hydroquinone combination treatments in South Africa before 1984 (Journal of Dermatological Treatment, 1997). So I definitely would not recommend using hydroquinone with any of the new resorcinol skin lightening treatments, including Clarins Vital Light Serum and philosophy™ Miracle Worker™ Dark Spot Corrector. While I love these products on their own, I would not recommend combining them with any treatments containing hydroquinone, even for those with lighter skin types.

4.) Do NOT get hydroquinone anywhere near your eyes. 

hydroquinone_in_eyes

Despite popular belief that hydroquinone may cause cancer, hydroquinone's most serious human health effect is pigmentation of the eye and permanent corneal damage (Journal of the European Academy of Dermatology and Venearology, 2006). While this only occurs when the eye is directly exposed to hydroquinone, it is still a risk factor. It is therefore vitally important to avoid the eye area in applying hydroquinone-based creams.

5.) Hydroquinone has NOT been directly linked to cancer in humans - only mice. 

Some believe that hydroquinone may cause cancer, but this is false. How this rumor arose stems from a study that demonstrated mice exposed to hydroquinone developed liver tumors.

However, these results were reported in a misleading fashion, as dermatological experts explained in a 2006 review in the Journal of the American Academy of Dermatology: Instead of being harmful to the skin, hydroquinone increased the number of benign (non-cancerous) liver tumors, reducing the proportion of cancerous liver tumors in the mouse, showing a protective effect of hydroquinone. (For you science buffs out there, there was an increase in hepatic adenomas and a decrease in hepatocellular carcinomas).

As for other studies associating mouse kidney tumors with hydroquinone use, it has been argued that these are not relevant to humans. As Dr. David J. Goldberg, a clinical professor of dermatology at the Mount Sinai School of Medicine states, "Over 100 scientific articles confirm hydroquinone is a safe topical for humans; no independent studies prove the opposite."

Bottom Line

Of the skin-lightening and age spot-brightening agents out there, 4% hydroquinone is the most effective. Overall, it is considered to be safe, but it's important not to use hydroquinone in conjunction with any creams containing peroxides or resorcinol, to avoid the eye area completely, and to switch off with other agents every four months to lower the risk of ochronosis (skin darkening from the build-up of homogentisic acid). In addition, if you have darker skin, you may wish to speak to your dermatologist first, as ochronosis is much more common in those with darker skin tones. I hope this guide helps you. Please, keep the great questions coming!

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Date: February 28 2012 at 9:46 AM
Skin Care, hydroquinone, hydroquinone and cancer, hydroquinone in eyes, resorcinol and hydroquinone, hydroquinone usage

Comments (17)

  1. B
    February 28 2012 at 10:16 AM

    Great post, thank you. I had heard that you should use hydroquinone in cycles, but I didn't know any of the other stuff here. Perfect timing too - I just started using Ambi Fade cream after reading your post on it!

  2. ABC
    February 28 2012 at 11:15 AM

    Hi! I'm currently washing my face every other day with Neutrogena Clear Pore Cleanser/Face mask that has 3.5% benzoyl peroxide and using a Alpha Hydrox targeted skin lightener with 2% hydroquinone. Would this combination be detrimental to my skin, even if the benzoyl peroxide is going to be washed off? Thanks!

  3. Leah Argento
    February 28 2012 at 4:21 PM

    Thank you for this informative article!

  4. Polarbelle
    February 28 2012 at 4:49 PM

    Great post. I was under the impression that hydoquinone was taken off the market awhile back. I used to use it and loved it when Serious Skin Care on HSN had it. I didn't know any of these facts about it. Hopeful that I can stumble into some in the future.

  5. Kira
    February 28 2012 at 5:18 PM

    What about using Kojic Acid and Vit C serum togehther in the morning, and Retin-A at night? I have been using Obagi forever, yr post is a great reminder that it is time to give it a break...thnx! Also are there any light serums with Kojic Acid 4%? I love CE Ferulic, and want to add that on top but am looking for least unnecessary ingredients and lightest formulation possible...THNX again:-)

  6. Jessica Allison
    March 1 2012 at 8:11 AM

    Nicki, you're a wealth of knowledge- thanks so much for writing this! I knew if anyone could get down to brass tacks about an ingredient, it was you! I've done some research on it in the past, but there were still some issues nagging at me! To help answer Kira's question: there are several studies showing the benefits of using a therapy that combines Retinol and Hydroquinone. The prescription cream Tri-Luma is actually a combination of those ingredients with an added anti-inflammatory ingredient. Since hyrdroquinone inhibits melanin production and the retinol encourages more "healthy" cell production, it would seem reasonable to assume that using the two together could reduce the recurrence of the pigment once the hydroquinone use is decreased or stopped. Indeed, most of the studies I found support the idea that combination therapy is indeed more effective. I will add that most of what I saw in regards to hydroquinone treatment referred to at least an 8 week course of DAILY treatment. Retinol can be hard to use on a daily basis until your skin is acclimated to it, so I personally would only start a combination therapy after using retinol alone for some time until my skin was past the initial irritation. Also, just a little tidbit on the subject of pigment returning when hydroquinone use is discontinued. It seems to be very important to employ a "maintenance regiment" after you achieve your desired lightening results. Alternating 4-month cycles like Nicki suggests, or tapered use of hydroquinone (rather than daily use, you'd apply 2-3 times weekly for a couple months, then just once a week for the next few) may be useful in keeping the pigment from popping back up over the long-term. Finally, it might be helpful to know that I did see evidence on this subject said that even those people who do see relapses in their hyper-pigmentation still have an overall improvement, so the idea of the spot recurring shouldn't stop people from seeking treatment. Thanks again Nicki, you're the best!

  7. Fdarling
    May 31 2012 at 8:02 AM

    I am not sure if i have ochronosis on both of my cheeks but i know they are sun induced while using products to get rid of my melasma patch. It worsened. I recently purchased "Dr Lewinn Skin tone perfecting serum" while reading great reviews on MakeUpAlley , as well as another product called Nadinola which contains 3%HQ. The past 3 nights i would use the serum wait for it to dry then apply nadinola over top that! 3 nights is all it took to darken. I came across this post today. I googled the ingredients to Dr.Lewinn's serum low & behold...resorcinol...O...EM....GEE! Thank God you saved me, you are truelly a life saver! I have eradicated Dr.Lewinn's serum I am stearing clear of resorcinol for now. I will try Nadinola on its own on those spots and monitor it closely. Thanks for saving me! Pray for me that this works!

  8. Nicki
    June 1 2012 at 8:04 AM

    @Fdarling - Wow, so glad to hear you have benefited from the site. Please keep it posted on how things work out with Nadinola!

  9. Tourniquet
    June 22 2012 at 11:27 AM

    I have darkened my face due to harsh scrubbing and tanning...should i use hydroquinone tetrotin momentasone furoate as adviced by a derm.i showd hm my face and he wrote facial hyperpigmentation

  10. Tourniquet
    June 22 2012 at 11:35 AM

    I was fair in my childhood,due to playing a lot in the sun.i started tanning..LaTEr in my 9th standard i started using apricot scrub and my face started worsening..then i used a cloth washing scrubber harshly on my face.i got my forehead ,both side of my face darkened with a dry rough skin over those areas...i tried a lot of homemade treatments and all.itz been 5 years but my facial colour hasen't regained.should i use hydroq,tetro an momentasone as told above..plz help.im just 20....proper guidance plz..i dun wanna worsen things up

  11. kandyce
    September 9 2012 at 9:30 AM

    Topical products inhibit and lighten, maintenance is necessary, but what would actually remove hyperpigmentation/age spots on the face and decolletage more Permanently? After lighteners, microdermabrasion and chemical peels, step up's would be IPL, Allumera plus IPL, then beyond that it's other laser treatments like non-ablative fractional or ablative fractional lasers, yes? And then topical products for some maintenance. Any suggestions for more permanent dark spot removal?

  12. Liz
    January 1 2013 at 5:16 PM

    I hope you are still monitoring comments here as I have had trouble finding answers on life after hydroquinone. I have used Obagi-C for about 6 months to treat sun related melasma. I have had great results and am ready to move on. I took a couple week break halfway through and my face went crazy. I have very combination skin and frankly it's been in the best shape of years using the obagi-c for dry/combination skin. I would like to try something without lighteners, but cannot find good suggestions of what to use to keep my skin from getting out of whack--is there anything that is a good system or product post hydroquinone without lighteners? Know that I also plan to try having a baby soon so want something safe for pregnancy as well. Thank you - I appreciate this post as there is very little information out there.

  13. Juanita
    February 11 2013 at 1:25 PM

    Could the combination of Kojic Acid and Licorice Extract exfoliate callous skin from the heel of the foot?

  14. meistershave
    February 26 2013 at 3:15 AM

    Just purchased Cape Fear Naturals Kojic Acid Cream, which I use for general skin maintenance. Product seems to work and I have no great complaint; just a question: the cream has some sort of "grit" commingled in it. It looks as if one or some of the ingredients crystallized — an old batch, perhaps? The little crystals can break, but they don't melt readily or absorb into the skin. Just wondering if anyone has had a similar experience with the product.

  15. Heather Jezorek
    May 16 2013 at 7:24 AM

    Being a metabolite of benzene, hydroquinone has potential mutagenic properties. This is a good article, but fails to mention two important findings about the potential of hydroquinone to act as a carcinogen. 1) The Occupational Safety and Health Administration (OSHA) in the United States claimed “hydroquinone is mutagenic and has cancer-causing potential.” 2) In 1994, the Journal of the American College of Toxicology (now known as the International Journal of Toxicology) published “The Addendum to the Final Report on the Safety Assessment of Hydroquinone.” Its conclusion stated that “hydroquinone is a potent cytotoxic agent that causes mutations and alterations to DNA, and that it should not be used in any leave-on type of product; it is safe for rinse-off products when used in concentrations less than 1%.” Yes, the FDA still considers it safe, although it has said it would review the safety and so far has not.

  16. Braden Breckenridge
    July 26 2013 at 3:46 AM

    What sort of cleanser should I use? Currently I am using a 2% hydroquinone cream in conjunction with cleansing my face with Proactive twice a day.... Proactive's main active ingredient is benzoyl peroxide!! So naturally I jumped when I read your article...... Are there any certain cleansers you recommend that would be a better alternative? I certainly don't want to harm my skin. Much thanks, Braden Breckenridge

  17. SheWhoMustNotBeNamed
    September 26 2013 at 4:18 PM

    Is there anything wrong with using hydroquinone and sulfur?

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