Hydroquinone is a skin-bleaching or skin lightening ingredient that may be used anywhere on the face or body to lighten areas of darkened or hyperpigmented skin such as freckles, chloasma (skin darkening caused by hormones), melasma (general skin darkening) and age spots (sometimes referred to as solar lentigenes).
Preparations containing hydroquinone are only available in certain countries. In most countries including the USA and New Zealand a 2% preparation is available without a presription. In Canada, however, hydroquinone is available as a 2% or 4% cream for topical application without a prescription and may be purchased from most pharmacies.
Hydroquinone is available in a number of skin lightening products including Lustra,Glyquin XM, Neostrata HQ, and Ultraquin. All may be purchased as a dual sunscreen/skin lightening products. Lustra, Glyquin XM and Neostrata HQ have the added benefit of glycolic acid, an exfoliant that helps to increase the efficacy of hydroquinone by gently removing dead skin cells on the skin surface. Ultraquin does not contain an exfoliant but can be used in conjunction with one. Products such as MaMa Lotion (an alpha hydroxy acid preparation) and Green Cream (a retinol preparation) will complement the action of Ultraquin and other hydroquinone preparations.
How does hydroquinone cream work?
Hydroquinone works by decreasing the production and increasing the breakdown of melanosomes (melanin pigment granules) in the skin's pigment cells (melanocytes). Melanin and melanocytes are responsible for skin coloring. Hydroquinone does this by inhibiting the activity of tyrosinase, the enzyme needed to make melanin.
How effective is hydroquinone cream?
In most cases, some skin lightening will be apparent after 4 weeks of treatment. Though it may take longer to see complete results, generally within 8 to 12 weeks. If no skin lightening effect is seen after using a hydroquinone product after 3 months, then treatment should be discontinued.
You can maximize the effectiveness of hydroquinone by staying out of the sun, wearing protective clothing or using a broad spectrum UVA/UVB SPF 15 or higher sunscreen when outdoors. Because protection from the sun is so important when using a hydroquinone preparation, you may want to consider purchasing a hydroquinone preparation with UVA/UVB protection for use during the day and one without for use at night. Alternatively, you may purchase one product without SPF and combine it with a really good sun blocker that contains active ingredients like Mexoryl SX, Mexoryl XL, Titanium dioxide, Avobenzone, Tinosorb M or Tinosorb S.
Brands such as Anthelios or Bioderma Photoderm Max block against both UVA and UVB rays and deliver high SPF protection. Hydraphase UV SPF 30 is a moisturizer plus UVA/UVB sunblock in one and is an excellent choice for normal to dry skin types. Sunlamps and tanning salons should be avoided.
Hydroquinone should be used regularly until desired results are achieved. Use after that should be as required to maintain results. If no improvement is seen within 4 to 6 months, treatment should be discontinued.
Some photos of skin treated with hydroquinone 4% crea
Before Treatment After Treatment
How to use hydroquinone cream
As with most skin preparations it is wise to test for skin sensitivity by applying the cream to a small patch of hyperpigmented skin. If redness or itching do not occur within 24 hours, it's probably safe to begin treatment.
- Clean and dry the skin before applying a thin film of cream twice daily to the hyperpigmented area(s) in need of bleaching. Rub into the skin well.
- Apply just enough to cover the affected areas and avoid applying to normal skin, as this will lighten as well. Hence wash your hands after applying unless these are areas of treatment.
- Do not apply the hydroquinone near the eyes, mouth, and other mucous membranes.
- Avoid using other medicated topical products (particularly peroxide products) on the same area at the same time unless directed to do so by your doctor.
- When using non-medicated cosmetics, sunscreens, and moisturising lotions, apply hydroquinone first, then wait several minutes before applying them over the top.
Hydroquinone cream safety and side effects
Overall adverse effects with the use of hydroquinone tends to be minimal and there is a lot of research to support its safety. Preparations tend to be very well tolerated in over 30 years of clinical use. Some women may experience minor and temporary skin irritations including mild itching or stinging and reddening of the skin (irritant contact dermatitis). If these do not subside the cream should be stopped.
Side effects that should warrant stopping the cream and seeking medical advice immediately include severe burning, itching, crusting, or swelling of treated areas (possible allergic contact dermatitis) and any unusual skin discolouration.
The most serious adverse effect related to the use of hydroquinone is exogenous ochronosis. This disorder is characterized by progressive darkening of the area to which hydroquinone is applied. Exogenous ochronosis usually occurs in black patients who have used hydroquinone at high concentrations (i.e. over 4%) over many years. The risk increases if users are not diligent about avoiding the sun or using sunscreen when exposed to sunlight.
If melasma does not improve within 4-6 months, hydroquinone should be discontinued. Hydroquinone treatments are best used in conjunction with your physician.
Hydroquinone cream precautions
Do not use benzoyl peroxide, hydrogen peroxide, or other peroxide products when using hydroquinone. A temporary dark staining of the skin may occur. If accidentally used together, wash the skin with soap and water to remove the staining.
Hydroquinone creams may contain sodium metabisulphite that may cause serious allergic reactions (including anaphylaxis) in certain susceptible people.
Hydroquinone should not be used in pregnancy or when breastfeeding.
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