I’m going to set the record straight, hydroquinone is safe and effective. There are so many ingredients in skin care products which are allegedly controversial, but in my opinion no ingredient has had as much unjustifiable, bad press or adverse legislation as hydroquinone. Let me explain. Hydroquinone is often called a skin “bleach” but it really doesn’t bleach skin, when you put it on your skin it doesn’t dissolve pigment, hydroquinone is really a very effective ingredient at making the bodies pigment cells, the melanocytes, stop making new brown pigment. So, it doesn’t really drive the old pigment away, in a condition where you’re making too much pigment it just stops the body from making excess brown pigment. If you want the brown pigment you already have to go away, that has to come off the skin as the skin cells that have the extra pigment fall off. That naturally occurs on the twenty-eighth day of any skin cells life and that’s called exfoliation and you can actually accelerate exfoliation with glycolics and retinoids and make those cells come off sooner to help take away the darkness. Hydroquinone is available over the counter at 2% and by prescription up to 4% and when it’s used as directed it’s a very safe and effective way of helping reduce excess pigmentation. Hydroquinone like most other skin care ingredients can under some circumstances cause a little bit of irritation and if that happens if you stop using it the irritation goes away but that’s about a limit to the problems of hydroquinone, as we use it. So what’s the controversy? First of all, with rodent experiments where hydroquinone was put on the skin of rodents at very high concentrations, some of those rodents developed some tumors. I don’t see how you can extrapolate rodent experiments whose skin have a very different penetration barrier and in whom very high concentrations were put on which are just not relevant to human use of this product. It’s not like the rats were given the hydroquinone internally. Second of all, in Africa, people use much higher percents, not 2 or 4% but as much as 10 or 20% mixed with other ingredients that drive the hydroquinone even deeper and they use it over and over again on their entire skin surface not just on little spots and the reason they do this it to try to lighten their genetically determined dark skin. Well, under these circumstances, of complete overuse of concentration and too much a certain disease called ochronosis can occur and that results from a deposition in the skin of one of the chemicals that comes from the hydroquinone and that makes your skin turn a little bit blue or a little bit gray. Let me put that into perspective. I’ve been a dermatologist for over thirty years, as a part of my continuing education I go to national meetings; I go to local meetings, where one of the goals if to learn about the most unusual and interesting cases just to expand our horizons. In those thirty years I have never seen a case of ochronosis at any national or local meeting, much less having encountered it myself. This is the bottom line, I, like the FDA, believe that hydroquinone is still safe and effective.
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