Hydroquinone is a naturally occurring chemical that inhibits the enzyme that makes pigment in our skin. When used appropriately it offers a safe and very effective therapy to treat hyperpigmentation and dark spots. In my practice I use hydroquinone frequently for many of my patients that complain of uneven pigmentation, dark marks from acne, and melasma.
So you might ask, why does hydroquinone have such “bad press”. Well there are many reasons for this, some are valid and some are not so valid. The main problem with hydroquinone is that with continued long term use, hydroquinone has been associated with a paradoxical darkening of the skin. This condition is called ochronosis and is more common in other parts of the world where hydroquinone is used extensively without regulation. To avoid this rare but significant side effect, I educate my patients on its use.
First and foremost, hydroquinone should not be used for long periods of time. I try to limit treatment to 1 to 3 months. Then I switch to an alternative therapy to maintain results. Secondly, hydroquinone must be used with sunscreen. Many dermatologists believe that sun exposure (without sun protection) may be implicated in ochronosis. Last but not least, I always emphasize to patients that if there is any significant irritation they should discontinue use. Some patients mistakenly believe that if the skin needs to be red or peeling for the product to work, however, with hydroquinone this could represent an allergic reaction that can heal with dark patches.
Following these simple rules, one can safely use hydroquinone to treat dark marks and hyperpigmentation. The good news is that new treatments are being developed that may offer the benefits of hydroquinone without all of the side effects. This is a big area of research in dermatology right now. I will keep you posted!