What Is Hydroquinone and Is It Safe to Use?

Skin before and after

In the quest for perfect skin, one of the most common problems for patients is that they often come up against unfamiliar chemicals and industry terms. When this happens, you need to research to find out exactly what you might be putting on your skin.

Failing to learn more means you could be risking long-term damage from either the wrong choice of product or an unforeseen side effect.

One such chemical is hydroquinone, an ingredient commonly found in specific skin-lightening products.

What Is Hydroquinone?

Hydroquinone is frequently found in skin-lightening products like bleaching creams. It works by limiting your production of melanin, the hormone that darkens your skin. While some people use it to lighten their darker skin, hydroquinone creams are most commonly used to lighten small, dark patches like sunspots or hyperpigmentation.

Creams with hydroquinone as an ingredient are an excellent non-surgical aesthetic procedure to help you achieve the skin you have always wanted. Unlike skin lightening surgery, hydroquinone creams are a cosmetic procedure that can be undertaken in the comfort of your own home after the initial consultation with your dermatologist. If you have dark patches or old sunspots, creams with hydroquinone can lighten them and – when combined with other suitable skincare ingredients – can help your skin recover from sun damage.

Why Is Hydroquinone Controversial?

Hydroquinone has a controversial history and has been banned at various times in the UK. The ban has primarily resulted from people using too high a concentration and doing permanent damage to their skin.

Hydroquinone has also frequently been misused. It must not be used as an all-over skin lightening treatment and such procedures should be avoided.

After much research, dermatologists have concluded that, in low concentrations, hydroquinone is safe to use and can produce some excellent results. However, it is only suitable for targeting small problem areas and not as an all-over, all-purpose fix.

The crux of the issue is that some companies were creating hydroquinone in exceedingly high concentrations in countries like Africa. They would also not provide aftercare, which meant patients weren’t informed that they shouldn’t go into the sun or wear sunscreen. Even people who aren’t using hydroquinone creams should take care to look after their skin during summer.

For those patients who use hydroquinone creams and then expose themselves to the sun, there is a risk that ochronosis can develop.

Ochronosis is a condition that causes the skin to darken where the cream was applied instead of becoming lighter. It is rare and typically only occurs with high concentrations of hydroquinone. When the correct dose is used, ochronosis is not an issue. However, should your skin become darker, stop using the cream immediately and consult your doctor as soon as possible.

A Quick Guide to Skin Lightening

Skin colour is genetically determined. Specialised cells called melanocytes create and release the brown pigment melanin that gives skin its colour and helps to protect skin against sun damage. There are many ways to lighten the skin by encouraging melanocytes to reduce or interfere with normal melanin production. Dermatologists use three effective treatments to manage medical conditions involving uneven skin colour, with long-term effects. They are: 

Hydroquinone: An irritant bleaching agent found in prescription formulations used under medical supervision.

Steroids: Anti-inflammatory compounds that can have a lightening effect and treat certain skin conditions.  

Laser treatment: To reduce pigmentation. 

By law, hydroquinone and steroids cannot be used in cosmetic products sold in the UK. However, many countries have not banned their use. Hydroquinone products purchased from overseas suppliers may contain them. UK Trading Standards agencies have identified imports of skin lightening creams containing hydroquinone, steroids, and mercury. The battle against illegally imported skin lightening treatments like hydroquinone creams is ongoing.

How Does Hydroquinone Work?

For some people, melanocytes produce excessive amounts of melanin, resulting in dark patches of skin — a condition known as Melasma. These can appear as grey-brown patches, normally on the cheeks, nose, chin, forehead, and upper lip. In some cases, dark patches may also appear on the neck and the arms.

Although it’s women who are normally affected by Melasma, it does affect a small number of men too. Melasma is also very common among pregnant women due to the fluctuation of their hormones. Sun exposure can also be a common cause of the condition.

Whatever your reasons for considering using creams with hydroquinone, it’s vital you discuss treatment with a trained professional. The effects are not immediate, and you will need to apply the hydroquinone cream correctly for the time specified by your doctor. Generally, it takes around four weeks for effects to become noticeable, although some patients may find that it takes longer to see visible results with even the best hydroquinone creams.

What Skin Conditions Can Benefit from Hydroquinone Creams?

The most common use for hydroquinone creams is to treat skin conditions that cause hyperpigmentation. Besides Melasma, these conditions include:

– Acne scars

– Age spots

– Freckles

– Psoriasis and/or eczema marks.

What’s often overlooked by those untrained in the use of hydroquinone is that it can’t treat actively inflamed areas. Hydroquinone creams can certainly help with old acne scars, for example, but they can’t help if you currently have an active acne breakout that’s causing dark redness.

What Are the Side Effects of Using Hydroquinone Creams?

Almost all medicines have side effects and creams with hydroquinone are no different. Some of the side effects of using hydroquinone creams are no different to any change to your skincare regime, such as irritation.

But, if your skin is particularly vulnerable to contact dermatitis or skin irritation, hydroquinone creams may not be the best option for you. In such cases, contact the team at Harley Street MD to discuss more suitable treatment options.

One of the most well-known side-effects of hydroquinone cream is that patients can often find themselves more susceptible to ultraviolet (UV) rays and sunburn. While you should always make sure to wear sunscreen on bright days, if you’re using a cream with hydroquinone, you should apply sunscreen with a high sun protection factor (SPF) even on cloudy days. Hats and jackets can also help to protect your skin on bright days.

You’ll need to keep your skin protected throughout the hydroquinone cream treatment, which can be a long process. Remember that hydroquinone isn’t a quick fix. If you don’t adequately guard your skin against UV rays and hydrate your skin during your treatment, there’s a risk your dark spots will reoccur and may become darker than they originally were.

Of course, when patients are treated with hydroquinone cream by our trained medical experts, we can advise them about how to use the medication without exposure to risks.

The most common reason for health risks to arise — and the main reason why hydroquinone creams are considered controversial — is that many people order their hydroquinone creams online. Those creams with hydroquinone will rarely if ever, conform to the necessary safety standards.

Using skin lightening products that you find online is always going to be a bigger risk. The side effects of using those treatments can be extremely serious and include:

– Permanently bleached skin

– Visible blood vessels

– Skin becoming thinner

– Uneven and patchy skin 

– Redness, irritation, and in some cases, a stinging sensation.

Patients who use creams with hydroquinone without professional medical supervision and advice will find that some side effects can be permanent, even if they stop using the medication.

One of the most serious side effects of using creams with hydroquinone that haven’t been medically approved is liver and nerve damage, as unapproved medications can contain toxic mercury as well as hydroquinone. Creams containing mercury can lead to serious problems with the liver and — if used during pregnancy — can also lead to fetal abnormalities.

However, using approved creams with hydroquinone makes it unlikely that any serious side effects or adverse health conditions will occur. That’s why it’s so important to ensure you only use hydroquinone creams under direct medical supervision.

What Is the Hydroquinone UK Regulation?

Illegal skin lightening treatments are a growing problem in the UK. Low-quality, counterfeit medicines are consistently in the news, and the fight against online suppliers that sell subpar or dangerous medicines is ongoing.

Many local councils have warned about the high number of substandard and toxic medications available to the general public. Currently, it is illegal to sell hydroquinone products such as creams in the UK without the necessary medical license. Anyone selling hydroquinone creams without that license risks prosecution.

Are Hydroquinone Creams Safe for All Skin Tones and Skin Types?

Whatever skin type you have, talk to medical experts before you consider making use of hydroquinone creams. While most skin types will tolerate hydroquinone perfectly well, some exceptions do exist.

People with dry or sensitive skin may find that using hydroquinone creams results in skin that is even drier or more irritated. In some cases, those side effects can start to fade as the skin begins to adjust to the hydroquinone.

In terms of skin tone, hydroquinone creams are best suited to those people who are fairer. Those with medium to darker skin tones should consult their dermatologist or skin specialist before beginning any treatment involving hydroquinone creams. That’s because using hydroquinone medications with a darker skin tone can result in accelerated hyperpigmentation.

At Harley Street MD, we recommend the use of Obagi and ZO. Both have a hydroquinone concentration of 4%. This concentration has been approved for long-term use by the FDA in the US and the CE in Europe and it works very well. 

Will Creams with Hydroquinone Work for Me?

If you’re researching whether or not hydroquinone creams are a suitable treatment for your skin, we can help. The first step is to identify your skin type, so you know more about the best ways to look after it. We can help you with this to ensure you only ever get the treatment that’s personalised to your specific needs.

The most important thing to remember is you should never buy creams with hydroquinone from an online store. In the UK, hydroquinone creams can only be prescribed legally by a trained doctor. If you buy online, not only will you have no idea of the ingredients in that cream, but you could also be exposing yourself to serious health risks. 

After your initial consultation, your dermatologist will give you a prescription for a skin lightening cream with hydroquinone. They will use a cream with no more than 4% hydroquinone in conjunction with the frequent application of an SPF 30 sunscreen for the best results. Solutions of 2% are the most readily available, while 4% hydroquinone creams can only be prescribed in the most challenging cases.

If you’ve been seeking a fix for your hyperpigmentation or sun damage, hydroquinone can help you. If you’re still unsure or worried about ochronosis or other side effects, there are plenty of alternatives that can help you achieve the same results.

 Alternatives to Hydroquinone Creams

If you’re worried about using creams with hydroquinone, then your first step should be to speak to your dermatologist. If you don’t yet have one, make sure you choose the right cosmetic clinic to get your treatment. At Harley Street MD, we can always help you find alternative solutions tailored to your skin tone and type.

Products that contain kojic acid, vitamin B3, or vitamin C are all-natural alternatives present in hydroquinone-free skincare. Products with arbutin, a bearberry plant extract, is also frequently used as a natural alternative to hydroquinone. It acts the same way as hydroquinone by slowing down the skin’s melanin production to lighten the skin over time.

Hydroquinone Cream UK

When used with caution, hydroquinone creams are an excellent option for lightening your skin. Although there are several side effects to consider, you can rest easy knowing that dermatologists have put plenty of research into ensuring this product is safe for you to use.

At Harley Street MD, we have one of the most trusted brands of hydroquinone products available: ZO Skin Health. If you have hyperpigmentation or sun damage and are interested in hydroquinone creams, book a free consultation with us today.

Founder at Harley St M.D.
Dr. Chia Tan is a UK trained medical doctor that specialises in cosmetic and aesthetic medicine and testosterone replacement therapy. He is qualified as a medical doctor since 2003 and has since trained extensively. He has been featured in several leading magazines as well as invited to appear on TV to discuss aesthetic medicine and the latest cosmetic procedures.
Dr. Chia Tan
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