Raechele Cochran Gathers, MD Dark spots on the skin, also called hyperpigmentation, are one of the most common skin care concerns. People with darker skin types often suffer more from hyperpigmentation and dark spots. Skin of color is highly sensitive and can develop dark spots (called post inflammatory hyperpigmentation) from irritation, rashes, acne—and even bug bites!
Uneven darker patches on the skin can also be caused by aging, sun exposure, endocrine problems, certain medications, hormones and other causes as well. Dark patches and hyperpigmentation can be psychologically distressing and even depressing. Hydroquinone is a common treatment used to fade dark spots and and improve hyperpigmentation.
What is Hydroquinone?
Hydroquinone is a chemical skin bleaching agent that has been around for more than 50 years. Hydroquinone works by decreasing the production of melanin. Melanin is what gives the skin its brown color or pigment. By blocking the production of melanin, hydroquinone can fade dark spots on your skin and help to even out your complexion. In the US, hydroquinone products are typically available by precription.
Risks of Using Hydroquinone?
Many people are concerned about the safety of hydroquinone. It has been in the news quite a bit over the last few years, and is banned in European and Japanese markets. Over-the-counter hydroquinone is not typically available in the US. Irritation and inflammation of the skin can be common short term side effects from hydroquinone. Also, in some sensitive people, rash can develop. Hydroquinone can also cause a halo of lighter skin around the darker area that you’re trying to lighten. Luckily, though, this usually resolves pretty quickly.
Hydroquinone can also potentially cause a bad side effect called ochronosis, where the skin develops a blue-brown discoloration that can be permanent. This is quite rare in the US. Ochronosis is more commonly reported in some African countries where people were using much higher concentrations of hydroquinone (higher than the 4% prescribed in the US). However, ochronosis has also been reported with use of a lower concentration of hydroquinone.
Hydroquinone and Cancer Risk?
Hydroquinone was banned in Europe and parts of Asia due to concern and controversy about cancer risk from the drug. Carcinogenic (cancer causing) risk has been reported in animals, but there is limited data in humans.
Hydroquinone Alternatives
There are many other chemicals and ingredients that are used to decrease hyperpigmentation and even the skin tone. Hydroquinone is often paired with prescription retinoid products, which help to reduce hyperpigmentation. Other useful ingredients to help to lighten dark spots include kojic acid, licorice root, soy, vitamin C, niacinamide (a form of vitamin B3) and arbutin (derived from the bearberry plant).
Don’t Forget Sunscreen!
Sun protection is essential for keeping your complexion even. Hydroquinone and other skin lightening agents are not as effective if you don’t practice good sun protection. You’ll need at lease an SPF 30 sunscreen, and you’ll need to wear it rain or shine. If you’re expecting to be in the sun for prolonged periods of time, you’ll need to reapply it every 2 hours too! Check out these tips on picking a sunscreen.
