I’m going to get all Carrie Bradshaw on you for a minute and talk about men. (Don’t worry, this has a point). A few years back, I dated a man who was smart, funny, and attractive. He wasn’t the love of my life, but we got along.
But my friends and family really didn’t like the guy. Even my friends who aren’t the type to judge or criticize would offer upon asking, “Well, as long as you are happy, that’s all that matters.” Ouch.
It didn’t last — he went this way, I went that, but I often wondered, Was he really that bad? What did they see that I didn’t?
It’s the same way with hydroquinone.
Since 1982, hydroquinone has been FDA-approved for the treatment of freckles, melasma, and general brown patching. Worldwide, hydroquinone is still the most commonly used bleaching agent. People who love hydroquinone absolutely love it, because it works. I’ve personally been a supporter of it for a long time. (Am I just too willing to give a rave review to men and products?!)
Yet the EU has banned hydroquinone in concentrations greater than 1%, and there is a growing number of people online who want to see this ingredient banned, once and for all. So I’m going to break down the facts — what is good about it, what is not-so-good about it — and let you decide.
Hydroquinone Is Effective Because It Works In Two Different Ways
Most skin lighteners work by inhibiting an enzyme, tyrosinase, which is necessarily for pigment (melanin) production within the skin. Hydroquinone also works in part by inhibiting the activity of tyrosinase.
However, unlike skin lighteners like kojic acid, mulberry extract, and peptides, hydroquinone also works by increasing the cytotoxicity of melanocytes (melanin-producing cells). Essentially, this means that hydroquinone can kill melanin-producing cells within the skin.
Because of the drastic difference in effects I’ve seen in people using hydroquinone-based products, I believe that cytotoxicity is greater than tyrosinase inhibition when it comes to fighting hyperpigmentation and lightening the skin in general.
The Concentration of Hydroquinone Matters When You Have Dark Skin
If you are of South Asian/Indian, Middle Eastern, Hispanic, or African descent, you may want to avoid using hydroquinone without the supervision of a physician. Though very rare (1 in 100,000 cases), according to the American Journal of Clinical Dermatology, use of hydroquinone in concentrations of 2% or greater can cause a condition known as exogenous ochronosis. This is a reflexive darkening of the skin — exactly the converse of what you want when using hydroquinone! It is worsened with sun exposure. As such, those with darker skin may wish to take extra precautions in avoiding products with excessive sun exposure when using hydroquinone products.
Yet, 1 in 100,000 isn’t significantly high enough to say all dark-skinned individuals should avoid hydroquinone. According to Dr. Susan C. Taylor, M.D., a Philadelphia-based dermatologist who has literally written the book on darker skin, ”The maximum levels of hydroquinone currently allowed (2 percent for over the counter, 4 percent for prescription) aren’t dangerous. At worst, it might cause redness or irritation, but only if your skin is sensitive or allergic to the medication.”
Some Risky Formulations Contain Mercury
The biggest risk of hydroquinone use appears to be the fact that some formulations contain trace amounts of mercury, though these formulations found to contain mercury were produced only in Mexico, Africa, and the Middle East (Boston Globe, 2003). Mercury poisoning is associated with damage to the brain, kidneys, and eyes (Pediatric Clinics of North America, 2007), and unlike many other ingredients that are reported on the internet to be toxic, mercury actually is toxic in very low, realistic doses to be found in skin care creams.
Therefore, if you are using a skin care treatment with hydroquinone, take caution that it is not produced in Mexico, Africa, or the Middle East, just to be on the safe side.
Hydroquinone May Even Prevent Cancer
And in a 2006 review in the Journal of the American Academy of Dermatology, Dr. Jacob Levitt, M.D. reports that topical applications of hydroquinone in standard product concentrations are not carcinogenic to humans. According to Dr. Levitt, use of hydroquinone in murine (mouse) studies led to an actual decrease in murine hepatocellular carcinomas (cancerous liver tumors) but an increase in hepatic adenomas (benign liver tumors), suggesting protective effects of hydroquinone.
Dr. Levitt further reports that murine renal (kidney) tumors caused by use of hydroquinone do not appear relevant to humans after decades of widespread use, and murine leukemia has not been reproducible and would not be expected from small topical doses in humans as well. As such, it seems that topically applied treatments with hydroquinone are safe, as Dr. David J. Goldberg, a clinical professor of dermatology at the Mount Sinai School of Medicine reports, “Over 100 scientific articles confirm it is a safe topical for humans; no independent studies prove the opposite.”
In General, So Long as They Are Mercury-Free, Over-the-Counter Products with Hydroquinone are Safe and Effective
The risks of hydroquinone (see above) appear to be minimal. To be on the safe side, I advise using hydroquinone for no longer than 4 weeks, and then cycling off for 4 weeks. It is great to start using again come fall.
Overall, is hydroquinone safe and effective?
Unlike with boyfriends, it’s not good to listen to the opinions of others about hydroquinone. It works, and it is safe and effective, so long as the formulation is sourced in the U.S. or Europe, and you avoid the sun during its use. Based on the scientific literature, hydroquinone seems to be both safe and effective at this time. Talk to your dermatologist if you are interested in a prescription-strength hydroquinone treatment. . If you are using any type of products with hydroquinone, use a sunscreen daily, and try to avoid the sun for best results, and if you are using Tri-Luma, follow doctor’s orders and do not use for longer than eight weeks.
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