Isn’t it annoying when the most effective ingredients get a bad rep?
Case in point: hydroquinone. It’s by far the best treatment for any type of dark spots. Slather it on them twice a day and it’s guaranteed to lighten them up.
But, some countries (yes, South Africa and France, I’m looking at you) have banned it after rumours it causes cancer and other nasty stuff started doing the rounds.
Is this true? Are politicians really trying to protect us from serious harm or are they misunderstanding the science and being too hasty with their bans?
Hint: scientists say that a hydroquinone ban is an “unnecessarily extreme“.
Here’s the scoop on hydroquinone and why it’s not really that dangerous (but you should still use it with caution):
What Is Hydroquinone?
Also known as tocopheryl acetate, hydroquinone is a skin-lightener. It treats melasma, freckles, age and sun spots, and even the dark marks left behind by pimples – basically any form of hyperpigmentation and discolouration.
In the US, hydroquinone can be used in concentrations up to 2% in OTC products and 4% in prescription products.
Either way, make sure it’s housed in an air-tight, opaque tube. Hydroquinone oxidises (i.e. becomes ineffective) when exposed to light and air. You’ll know when this happen. Hydroquinone turns brown to warn you.
Related: How To Deal With Post-Inflammatory Hyperpigmentation (Acne Marks)
Struggling to put together a skincare routine that minimises wrinkles, prevents premature aging, and gives your complexion a youthful glow? Download your FREE “Best Anti-Aging Skincare Routine” to get started (it features product recommendations + right application order):
How Does Hydroquinone Work?
Hydroquinone lightens discolourations in two ways:
- It inhibits the activity of tyrosinase, the enzyme that controls the synthesis of melanin
- It increases the cytotoxicity of melanocytes (it kills the cells that produce melanin)
In plain English, hydroquinone stops the production of excess melanin in its track, allowing skin to slowly go back to its original colour.
Related: The Battle Of The Skin-Lighteners: Which Is The Best Alternative To Hydroquinone?
Does Hydroquinone Cause Cancer?
Rumour has it, hydroquinone will kill you. The “proof”? Hydropquinone can cause cancer in rats.
Never mind that we’re not rays and that those poor animals were injected or fed high amounts of hydroquinone. *sighs* Anyone who understand how to read a scientific study will tell you that these studies simply don’t apply to humans. Especially not when humans use a tiny amount on a small area of skin.
Plus, as Dr Levitt points out in his “The safety of hydroquinone: A dermatologist’s response to the 2006 Federal Register“, hydroquinone increases benign liver tumours in mice but it DECREASES cancerous liver tumours. This suggests that hydroquinone may actually have a protective effect!
So, nope, there’s NO proof that hydroquinone causes cancer in humans.
Does Hydroquinone Cause Ochronosis?
Ochronosis. It’s a bluish black discoloration of the skin caused by a build-up of tyrosine or phenylalanine. It’s more common in people with dark skin, but everyone can get it.
Luckily, it’s rare. According to Dr Levitt, “a literature review of exogenous ochronosis and clinical studies employing hydroquinone (involving over 10,000 exposures under careful clinical supervision) reveal an incidence of exogenous ochronosis in the United States of 22 cases in more than 50 years”.
Its rarity makes it difficult to figure out why it happens. It’s obvious hydroquinone alone can’t be the cause or everyone who uses it would get it.
The most popular theories believe you get ochronisis when you use hydroquinone with resorcinol (another ingredient that treats hyperpigmentation) or without sunscreen. If you don’t use one, the theory goes, your skin tends to produce more melanin to protect itself from the sun, compromising the efficacy of hydroquinone.
Bottom line: if you use hydroquinone with sunscreen and without resorcinol, you should be fine.
Does Hydroquinone Cause Irritations And Allergies?
It’s not over. Hydroquinone is accused of causing irritations and allergies, too.
If you have sensitive skin, hydroquinone is as guilty as charged. Like all the most powerful ingredients, its effectiveness comes at a cost: redness and irritation.
To minimize irritations, derms recommend you use hydroquinone in a 4 months cycle. This means using hydroquinone for 4 months, then switching to another skin-lighter (for example, azelaic acid) for 4 more months, then back to hydroquinone for 4 months. You get the drill.
Related: Is Azelaic Acid The Best Alternative To Hydroquinone?
What Are The Best Products With Hydroquinone?
- Alpha Skincare Dual Action Skin Lightener ($10.99): available at Ulta
- Paula’s Choice Resist Triple-Action Dark Spot Eraser 7% AHA Lotion ($27.00): available at Nordstrom and Paula’s Choice
The Bottom Line
Hydroquinone is the most effective way to treat hyperpigmentation. It won’t give you cancer, rarely ochronosis, and sometimes irritations (but there are tricks to minimise this). Just remember to put your sunscreen on!
This is beyond helpful. I have a dark spot remover with hydroquinone in it and I’ve been on the fence about using it. I’m all over it now!
Brittany, I’m glad you found it helpful. 🙂
From the article above, it looks like the reason for using Hydroquinone in cycles is to reduce irritation. Is this the only reason for cycling off of it? If I do not experience irritation (or if the irritation is tolerable), do I still need to cycle off of it? My dermatologist recommended 6 weeks on, 6 weeks off. Hydroquinone is extremely effective in controlling my melasma when I am on it, but within the first 2 weeks off the melasma comes right back, despite religious use and reapplication of broad-protection sunscreen (eltaMD). I have not tried alternating it with Kojic Acid, not sure why my dr has not recommended this solution.
Jennifer, yes you cycle it off to reduce its side effects. But I wouldn’t recommend alternating it with nothing. If you have melasma, you need to use something else in the meantime. Kojic acid may help. You could also try azelaic acid.
I have been using melacare for two month (2%hq,tretinoin.025,mometasone fu
Preservativee:methyl paraben ip 0.18%, propyl paraben .02%
Hyperpigmentation had faded
May I use eucerin even brighter which contain resorcinol during the off period.
Devika, yes, you can.
It’s ok to use all over the face or shoul I use only on top of the dark spots?
Tatiana, only on dark spots.
Hi. Your information is so helpful. How would I layer hydroquinone with tretinoin? I’m not sure which to use first. Also, how long would I wait between applying products? Till they’re dry? Most websites give contradictory information. Thank you!
Vicky, as tretinoin is a prescription medication, I advise you to talk your doctor about how to use it with hydroquinone.
I think have Ochronosis. My OGB/YN put me on birth control (Provera) because I didn’t have regular periods(PCOS). What he failed to informed was that it changes your hormones and that it could change your skin tone to a darker tone without using sunscreen. For that reason I used a lotion with 2% Hydroquinoe to make my skin brighter and didn’t use sunscreen along with it (I honestly didn’t know about using sunscreen when using HQ).My face is now 4-5 shades darker and I feel so ashamed to go out without makeup. Do you think there is inexpensive way to reverse it without using skin lasers? Or is it permanent?
Alana, oh no! I’m so sorry to hear this. First of all, don’t feel ashamed to go out without makeup. You’re still a beautiful woman. A few dark spots don’t define you.
Unfortunately, hydroquinone can cause ochronosis, so using it may have made it worse. 🙁 It is possible to lighten it, but it rarely goes away completely. I suggest you see a specialist who has experience with ochronosis to see what the best treatment would be.