Hydroquinone for Hyperpigmentation and How to Use It Effectively
Hydroquinone is the gold standard for the treatment of hyperpigmentation and therefore is the most prescribed bleaching agent for treating melasma, freckles, lentigines, age spots and acne scars. Although hydroquinone has been controversial in the past, for over fifty years it has been established as the most effective ingredient for fading uneven skin tones and dark spots.
Hydroquinone is a depigmenting agent that can lighten dark patches in the skin. It works by decreasing the number of melanocytes present and does so by inhibiting the activity of tyrosinase, the enzyme that catalyzes melanin production. Hydroquinone helps limit the skin from creating an excess amount of melanin, which is what gives skin its color. Too much melanin clustered together leads to brown spots. Hydroquinone interrupts this process, causing brown spots to gradually fade.
Hydroquinone has been a topic of controversy in the past because early formulas for skin lightener products included mercury and glucocorticoids, among other caustic and illegal contaminants. Mercury itself is not a component of hydroquinone, and is not used in products formulated and sold in the United States. When mercury is mixed with high concentrations of hydroquinone in hydro-alcoholic solutions, it induces ochronosis. Ochronosis is a rare disease characterized by speckled pigmentation over the face and neck. When hydroquinone is limited to 2% in over-the-counter formulas and 4% for prescription formulas(as it is in the US- where products are regulated by the FDA), ochronosis is extremely rare.
Usage Recommendations
Hydroquinone can be used twice daily for up to five months consecutively. After five months, melanocytes should be allowed to stabilize during a two to three month break from hydroquinone. Active melanocytes in the affected areas develop resistance to hydroquinone, after several months which causes the patient's hyperpigmentation in these areas worsens.
In cases of hyperpigmentation, more melanin is present due to an increase in melanocyte production. By controlling these melanocytes with hydroquinone, your skin becomes more evenly toned over time.
It takes about four weeks on average for the ingredient to take effect. It may take several months of consistent use before the skin tone is completely even.
Some people can experience irritation, itching, or redness with hydroquinone. To check for skin sensitivity, do a patch test, applying a thin layer of product to the skin and leaving it on overnight. If there is no reaction, proceed to treat skin with hydroquinone.
When treating the skin with hydroquinone products, the whole surrounding area should be treated. It should not be used as a spot treatment. Using it as a spot treatment results in lighter patches and blotchy skin tone.
When applying the product, first make sure that the area is clean and dry. Apply a thin layer of product to the skin and rub it in well. Apply just enough to cover the affected areas and avoid applying to normal skin outside the area you are treating, as this will lighten those other areas as well. Always wash your hands thoroughly after using the product, so as not to not lighten the skin on your fingers. When using non-medicated cosmetics, sunscreens, and moisturising lotions, apply hydroquinone first, then wait several minutes before applying other products.
When using hydroquinone, sunscreen should be applied daily as hydroquinone can make the skin more sensitive to UV. Sun exposure can not only make hyperpigmentation worse, but also reverse the effects of your hydroquinone treatment. Be sure to reapply sunscreen throughout the day when using hydroquinone.
Topical hydroquinone is absorbed systemically so it should not be used on women who are breastfeeding and or pregnant.
Although hydroquinone can help fade red or brown spots that have lingered, it won’t help with active inflammation. The ingredient can help minimize acne scarring, but it won’t have an effect on redness from active breakouts.
If you have dry or sensitive skin, you may find that hydroquinone causes further dryness or irritation. This usually tapers off as your skin adjusts to the ingredient. People who have normal or oily skin are less likely to experience these side effects.
The ingredient tends to work best on fair skin tones. With medium-to-dark skin, hydroquinone may actually worsen hyperpigmentation.
Ingredient Combinations with Hydroquinone:
To suppress inflammation caused by factors such as diet, hormones, and sun exposure, combine hydroquinone with anti-inflammatory agents and antioxidants. Some of the best results are achieved through a combination of Vitamin A and hydroquinone. This combination encourages a natural and even color tone. Vitamin A facilitates the removal of pigment by accelerating the cell turnover while enhancing the penetration of hydroquinone in the skin. As well, Kojic acid, glycolic acid, lactic acid, Vitamin C and vitamin E are all great partners for hydroquinone.
Ingredients like benzoyl peroxide and resorcinol should not be used with hydroquinone. Combining the two, can cause temporary skin staining. When hydroquinone is combined with resorcinol, it is known to trigger ochronosis.
Hydroquinone is generally used in creams, serums or gels. It is often combined with hydroxy acids and Vitamin A in product formulations. Hydroquinone is prescribed by dermatologists more than any other ingredient for the treatment of hyperpigmentation. When used properly, it is extremely effective in reducing excess pigmentation, melasma, age spots, and acne scarring.
