What Is The Controversial Skincare Ingredient Hydroquinone?

Contouring hacks aside, sometimes your skin's dark patches are tough to hide. Either due to pregnancy, hormone medicines, sunburns, or birth control pills (via Healthline), those persistent "freckles" can seriously get in the way of your alluring appearance. Let's be honest: there is no need to beat around the bush. Beautiful, clean skin with an even complexion is critical to helping you look and feel your best!

So, you may have already tried several creams to lighten that hyperpigmentation or melasma spots, but to no avail, leaving you frustrated and, quite frankly, annoyed. When diligent exfoliation, vitamin serums, brightening creams, and rigorous skincare routines fail to rise to the occasion, where else could you possibly turn to?

Enter hydroquinone. Hydroquinone is a chemical compound used in skincare regimes as early as the 1800s, as plastic surgeon David Shafer, M.D., tells Byrdie. But what exactly is hydroquinone, and is the buzz justified?

How does hydroquinone work?

Hydroquinone is a valuable ally in our quest for perfect skin. After all, it effectively combats those persisting dark spots, acne scars, and hyperpigmentation. But how does it work exactly? At the basal level of our epidermis reside the melanocytes. According to research published in Advances in Dermatology and Allergology, these cells produce a dark pigment known as melanin inside our melanosomes. Melanin production is the primary function of our melanocytes, but sometimes these hard-working cells work too hard, producing more melanin than normal. This results in dark spots — known as melasma — on our skin. These spots are typically grey-black and appear on the nose, cheeks, chin, and forehead. However, dark spots may also be observed on one's forearms, although less frequently.

Hydroquinone interacts with the melanin-producing melanocytes and interferes with melanin production. This occurs by inhibiting the conversion of the tyrosine enzyme to DOPA (dihydroxyphenylalanine), reducing melanin, per the American Osteopathic College of Dermatology. Reducing melanin — the hormone responsible for darkening our skin — eventually helps to lighten those dark patches while preventing new ones from forming.

Skin-lightening creams typically include hydroquinone as a primary ingredient. However, as several different creams contain this chemical compound, how do you know which works best? Ava Shamban, a board-certified dermatologist, suggests to Byrdie that better results can be achieved when choosing a cream with 4% hydroquinone, 0.25 % tretinoin, and "mild over-the-counter cortisone."

Is hydroquinone for everyone?

According to the American Academy of Dermatology Association, melasma is a very common skin condition reaching a prevalence rate of as high as 33% among the population. Nevertheless, hydroquinone — albeit efficient in treating melasma — is not a treatment that should be taken lightly and is not for everyone. Furthermore, using it liberally could be a serious skincare mistake.

Dermatologist Sharon Garcia advises that residual light marks left by acne breakouts should be treated with mild brightening washes combined with a sunscreen with a high SPF instead of hydroquinone (via Advanced Dermatology and Skin Cancer Associates). One should only resort to using hydroquinone with stubborn marks that do not otherwise fade away.

Nevertheless, using hydroquinone does not mean that those persistent pigments will instantly disappear. On the contrary, noticeable results may take up to four weeks to appear, per Healthline. As David Shafer, M.D., tells Byrdie, the impact of hydroquinone takes place at the cellular level — meaning it takes time for the skin to shed the old cells and produce new pigment-free ones. However, the Buckingham Center for Facial Plastic Surgery cautions that results are not permanent, and interrupting hydroquinone will result in the skin's natural pigmentation resurfacing.

How hydroquinone positively impacts your skin

So, is the buzz really justified? Should you rush to buy a brightening cream that includes hydroquinone? Given the benefits of hydroquinone on your skin, this chemical compound is solidly gaining ground as a staple in skincare routines. So, yes, the buzz is justified. But if you are still on the fence about whether you should join "team Hydroquinone" here is a breakdown of how using it can positively impact your skin.

Firstly, hydroquinone lightens dark spots and is considered "the topical gold standard in dermatology for reducing hyperpigmentation," as Ee Ting Ng, a cosmetic chemist and the founder of hop&cotton, tells Byrdie. Secondly, due to hydroquinone's depigmenting properties, acne scars are reduced, and skin discoloration is evened out, resulting in a more balanced complexion (via WebMD). Moreover, a study originally published in the medical journal Acta Dermato-Venereologica has provided supportive evidence of hydroquinone's efficiency in treating post-inflammatory hyperpigmentation. Finally, melasma — a hereditary condition resulting in dark spots on the forehead, cheeks, and upper lip and triggered by hormonal changes and UV exposure — can be effectively treated with hydroquinone, as Shamban, M.D., tells Byrdie. However, if using hydroquinone has several benefits for the skin, why is it considered to be a controversial treatment?

Possible side effects and risks

As with any other type of chemical compound, the use of hydroquinone also entails possible side effects and potential risks. These side effects have brought hydroquinone under severe scrutiny, rendering its use a controversial treatment and even banning it in the U.K., Europe, Japan, and Australia. However, as Shamban, M.D., tells Byrdie, despite its bad reputation, there is no research-based evidence to indicate that the use of hydroquinone can lead to any serious harm. Being FDA-approved since 1982, hydroquinone is safe to use, but it does come with some possible side effects.

According to the Mayo Clinic, common side effects include redness, itching, and skin drying. In addition, excessive lightening of normal skin color around the affected spots may also be observed. While hydroquinone will brighten spots with hyperpigmentation, it will also inadvertently come into contact with the surrounding skin area, causing it to brighten up and result in what is known as "halo spots." Another potential risk incurred with prolonged use of skin-lightening creams that include hydroquinone is exogenous ochronosis, a brown-black skin discoloration resulting from "dermal accumulation of homogentisic acid," per VisualDx. So, instead of the desirable results of brightened skin, a darkening of the skin may be observed.

How to use hydroquinone cream

To avoid these side effects, dermatologist Purvisha Patel M.D., the founder of Visha Skincare, suggests using up to 4% hydroquinone lightening creams for a maximum of 12 weeks, giving your skin a break from the chemical afterward (via the Advanced Dermatology and Skin Cancer Associates).

You should always test the product on a small skin patch (such as the inside of your forearm) for potential allergens before applying it to your face. If your skin cannot tolerate the high-concentration cream, you can use an alternative over-the-counter cream with a lower concentration. Richard Bottiglione, an Arizona-based board-certified dermatologist, shares some crucial advice with Byrdie regarding the effective use of the cream. He suggests washing your face with a glycolic acid cleanser to thoroughly remove dirt and oil residues before applying the cream. Makeup and dirt residue can clog up your pores, preventing the cream from penetrating deep into your skin, thus reducing its potency. It is also crucial to apply a high-SPF sunscreen to protect the skin from tanning and sunburns.

There is no right or wrong on which part of the day you use the cream, but Shamban, M.D., suggests that nighttime — when cells regenerate — might be optimal to achieve better results.

Natural alternatives

If you're still concerned about using hydroquinone, you could turn to nature for help. Nature has always offered an abundance of products for our health, well-being, and beauty. So if you are still uncertain about whether you should jump on the hydroquinone wagon, you could try nature's treasure box instead, as there are some natural alternatives you could choose, per Healthline. Antioxidants such as vitamins A and C are typically used in anti-aging products and may help brighten dark spots and treat facial discoloration. Plant-based acids such as kojic acid may also help, according to Baie Botanique. Finally, vitamin B3 may prevent hyperpigmentation on your skin.

No matter where you stand on the "hydroquinone" debate, the results are impressive, but you should only venture to try it after being fully informed of the potential risks incurred and after professional consultation with your dermatologist. Granted, you might be weary of trying it out, but the benefits are hard to ignore. Once you demystify hydroquinone and debug some widely-held misconceptions, you will be one step closer to radiant skin free from black spots.