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Hydroquinone: shining a light on the controversial skin lightener

Looking to treat pigmentation, age spots or melasma? We reveal the pros, cons and side effects of this gold standard lightening ingredient

Have you heard of hydroquinone? This highly effective skin lightening ingredient works by decreasing the production of melanin in the skin, but is somewhat controversial as it is also known as a bleaching product which has gained a reputation for being used in an unregulated manner.

We investigate what it is, how it works and whether it might be right for you.

What is hydroquinone?

Hydroquinone is a plant-derived ‘cytotoxic’ skin lightener that’s primarily used to decrease the appearance of hyperpigmentation, melasma, age spots and freckles. It has to be used with caution however, as along with making skin thinner, more fragile and sometimes photosensitive, other complications can occur.

Banned for over-the-counter purchase, it can be issued on prescription in the UK at a concentration of less than 2 per cent, and must only be used under supervision of a doctor.

Due to its skin lightening properties and the outdated belief in some cultures and ethnicities that lighter skin is preferable, its unregulated use as a skin bleach has been widespread amongst African, Asian and Caribbean populations, leading to undesirable and sometimes even dangerous outcomes.

How does it work?

Hydroquinone works by inhibiting the production of tyrosinase, the enzyme that produces melanin – the pigment that gives skin colour. It does this by accelerating the melanocytes’ degradation and noticeable results, namely lighter, more even toned skin, will be seen after a couple of months of regular use.  

"Hydroquinone is a potent depigmenting ingredient that somewhat controversially remains the ‘gold standard’ for treating pigmentation, but it can be quite tricky to use and irritation and erythema are common side effects," cautions EV Expert Dr Sandra Gamper.

"When used to treat localised hyperpigmentation it may leave a ‘halo’ of depigmentation," she continues. "However, if it is applied to the full face there is the potential for it to unnaturally bleach the skin, potentially leaving an unnatural result where the facial skin may not match the rest of the body."

Is it safe and suitable for me?

 Hydroquinone needs to be treated with respect and used only under strict supervision of a doctor or skincare professional.

"One of the major concerns regarding hydroquinone is of a side effect that can occur called exogenous ochronosis," says Gamper. "This can cause a paradoxical darkening of the skin where users can be left with blue-black patches and bumps after unsupervised and/or long-term use."

If you’re interested in trying hydroquinone, it can be safely used for a limited period (around three months) and in conjunction with other ingredients and products.

The first thing to do is book a consultation with an accredited skin specialist such as one of our Etre Vous Experts, who will assess your skin and determine its suitability.  

A word of warning: never purchase hydroquinone over the counter or via an unregulated source; it must always be used under the guidance of a professional.

What are the alternatives?

If you are looking to treat pigmentation or hyperpigmentation without resorting to hydroquinone, you’ll be pleased to know there are safer, less risky alternatives that can help you achieve a more even skin tone.

Gamper suggests alpha arbutin, kojic acid, cysteamine, azelaic acid or liquorice root extract, along with the Cyspera product range – this can be used can be used in many areas of the body (including the underarms and lips), and is also ideal pre-and post procedure, particularly for clients with skin of colour.

However, if you’re only dealing with mild pigmentation, a good vitamin C product and daily sunscreen to protect against future damage may be enough to get your skin back on track.

Sandra Gamper, Aesthetic Doctor

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