Hydroquinone for skin lightening: Safety profile, duration of use and when should we stop?

  title={Hydroquinone for skin lightening: Safety profile, duration of use and when should we stop?},
  author={Tsz Wah Tse},
  journal={Journal of Dermatological Treatment},
  pages={272 - 275}
  • T. Tse
  • Published 5 August 2010
  • Medicine
  • Journal of Dermatological Treatment
Abstract Hydroquinone has been marketed in skin-lightening products for almost 50 years and remains as the most frequently used whitening constituent in the category. Issues and concerns have been raised regarding its potential dermatological and systemic side effects. These almost led to it being banned from the US market by the FDA in 2006. This article reviews its safety profile. The author also suggests on the duration of its use and advises on regular assessments by medical physicians. 

Hydroquinone: myths and reality

This contemporary review presents the strongest evidence supporting the use of hydroquinone with the most effective and tolerable formulations combining hydroquin one, retinoid and corticosteroid (modified Kligman formula or ‘triple combination cream’).

Hydroquinone-induced depigmentation: case report and review of the literature.

  • T. JowB. Hantash
  • Medicine, Biology
    Dermatitis : contact, atopic, occupational, drug
  • 2014
The development of depigmentation and paradoxical hyperpigmentation in 2 patients with Fitzpatrick skin type III/IV after brief treatment of their melasma with the HQ-containing Nu-Derm and Reverse systems is described for the first time.

Alpha Arbutin as a Skin Lightening Agent: A Review

A futuristic scope of α -arbutin as a safer alternative to other harmful skin lightening agents is presented and its wide applicability in the cosmetics and pharmaceutical industries is discussed.

The dangers of skin-lightening creams

The overall results indicate that many of the skin-lightening creams sold in the Saudi market contained one or more toxic ingredients that in most cases were not listed on the packaging.

Delivery of hydroquinone assisted by fractional laser for the treatment of hyperchromic scar

Fractional ablative lasers can be used to improve the delivery of topical drugs and the permeation of skin lightening agents, such as hydroquinone, can be optimized, and the treatment time can be reduced.

Cosmeceuticals for Hyperpigmentation: What is Available?

The article attempts to look at other alternative cosmeceuticals available or maybe upcoming in the future and describes the safety and efficacy of these agents and their advantage over the conventional therapy.

Trends in Use of Prescription Skin Lightening Creams

It is the dermatologist’s duty to gauge the effect of the pigmentation disease on patients’ life in order to counsel, tailor, and decide on the most appropriate treatment option.

Efficacy and safety of topical isobutylamido thiazolyl resorcinol (Thiamidol) vs. 4% hydroquinone cream for facial melasma: an evaluator‐blinded, randomized controlled trial

Thiamidol can be considered a suitable option for melasma patients with poor tolerability or treatment failure with hydroquinone, and it is shown that this study compared the efficacy and tolerability of topical 0.2% Thiamidols versus 4% hydroquinones for facial melasma.

Comparison of the efficacy of cysteamine 5% cream and hydroquinone 4%/ascorbic acid 3% combination cream in the treatment of epidermal melasma

Cysteamine, a non‐melanocytotoxic molecule is a safer alternative to hydroquinone and usable for long‐term use and has shown promise as a treatment for melasma.


AFBA was as effective as HQ 4% cream, however AE such as itching and skin irritation were more frequently seen in the AFBA group, but such AE did not require treatment or withdrawal, and further controlled, blinded, multicenter studies are required to support these results.



Hydroquinone and its analogues in dermatology – a risk‐benefit viewpoint

Hydroquinone (HQ) has been used since the 1950s in commercially available over‐the‐counter skin lightener products and since the 1960s as a commercially available medical product. It is also used in

Skin lightening preparations and the hydroquinone controversy

Alternative agents to inhibit skin pigmentation such as retinoids, mequinol, azelaic acid, arbutin, kojic Acid, aleosin, licorice extract, ascorbic acid and N‐acetyl glucosamine are examined as possible topical alternatives to hydroquinone.

The safety of hydroquinone

Despite 40–50 years use of hydroquinone for medical conditions, there has not been a single documented case of either a cutaneous or internal malignancy associated with this drug.

Complications of chronic use of skin lightening cosmetics

Skin lightening (bleaching) cosmetics and toiletries are widely used in most African countries. The active ingredients in these cosmetic products are hydroquinone, mercury and corticosteroids.

Exogenous ochronosis and pigmented colloid milium from hydroquinone bleaching creams

The study presented here covers the clinical, histological, histochemical, electron microscopical and pathogenetic features as seen in thirty‐five cases of hydroquinone damage to the dermis in South Africa.

Exogenous ochronosis: An overview

The combination of higher hydroquinone concentrations together with other preparations containing ochronotic agents such as phenol and resorcinol provided the basis for the high incidence of ochronosis (pre-1984) in South Africa.

Hydroquinone‐induced exogenous ochronosis: a report of four cases and usefulness of dermoscopy

Dermoscopy might become a valuable resource in approaching exogenous ochronosis and Dermatologists should be able to differentiate it from melasma and immediately discontinue hydroquinone.

The safety of hydroquinone: a dermatologist's response to the 2006 Federal Register.

  • J. Levitt
  • Medicine
    Journal of the American Academy of Dermatology
  • 2007

Disorders of hyperpigmentation.

Hydroquinone and the FDA--the debate?