Hyperpigmentation in skin is caused by an increase in melanin, the substance in the body that is responsible for color (pigment). Certain conditions, such as pregnancy or Addison's disease (decreased function of the adrenal gland), may cause a greater production of melanin and hyperpigmentation. Exposure to sunlight is a major cause of hyperpigmentaion, and will darken already hyperpigmented areas. Hyperpigmentation can also be caused by various drugs, including some antibiotics, antiarrhythmics, and antimalarial drugs.
An example of hyperpigmentation is melasma (also known as chloasma). This condition is characterized by tan or brown patches, most commonly on the face. Melasma can occur in pregnant women and is often called the "mask of pregnancy;" however, men can also develop this condition. Melasma frequently goes away after pregnancy. It can also be treated with certain prescription creams (such as hydroquinone). However Hydroquinone is a skin lightener used in many whitening creams and dark mark fade treatments. It reduces the production of melanin in your skin, so it is great for fading hyperpigmentation, acne marks, sun spots, melasma, and other skin discoloration issues. It is one of the active ingredients in the popular Obagi skin care line. Few years ago researchers have discovered that Hydroquinone is bad.
Why is Hydroquinone Bad?
Without a doubt, hydroquinone is very effective for treating hyperpigmentation issues. However, its safety is also highly questionable.
The reason hydroquinone gets such a bad reputation is because studies have shown that hydroquinone has some carcinogenic effects when applied to skin. It is considered cytotoxic (toxic to cells) and mutagenic. Studies have also shown that long term hydroquinone use can causeexogenous ochronosis, which is when your skin turns a bluish and black color. Hydroquinone not only inhibits melanin production to help lighten skin, but long term use can actually damage your pigment cells.
Other side effects of hydroquinone use include:
- Increased exposure to UV radiation
- Sensitivity to sunlight
- Increased risks of getting hyperpigmentation
- Contact dermatitis and skin irritation
- Thick, leathery, and bumpy skin
Because hydroquinone decreases the melanin pigments in your skin, your skin becomes more sensitive to the sun. This increases UVA and UVB exposure, which in turn, increases the risk of getting more future hyperpigmentation, especially if you don't use a photostable, highly protective sunscreen at all times. Hydroquinone also turns toxic when exposed to sunlight, so if used, it should only be used as a spot treatment (not all over the face) at night. Aside from exogenous ochronosis and sun sensitivity, long-term hydroquinone use is also known to cause skin to get thick, leathery, and bumpy. Short-term side effects of hydroquinone include redness, irritation, and contact dermatitis.
Because of these associated risks, hydroquinone has been banned in many countries in Europe and Asia. In the US, 2% hydroquinone products can still be found over-the-counter, but 4% (which is usually the maximum strength) hydroquinone products are only available with a doctor's prescription.
Should you use Hydroquinone?
If you have extremely stubborn hyperpigmentation issues that absolutely do not respond to any other kind of treatment (i.e. chemical peels, microdermabrasion, retinoids, laser, etc.), hydroquinone may be your skin's last resort. What hydroquinone is to hyperpigmentation is what Accutane is to acne. Hydroquinone should only be used if and only if you have exhausted all other treatment options. I personally would stay away from hydroquinone just because of the safety dangers and side effects associated with it. If all other countries have banned the use of hydroquinone in skin care products, that should tell you something about its long-term safety. For skin lighteners, chemical peels, lightening serums and vitamin C are possible alternatives. While hydroquinone is effective for fading dark skin discolorations, it should not be taken lightly because of its questionable safety.
