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When it comes to skincare, there are a few ailments that require a tad more than TLC to combat (we're looking at you, dark spots, hyperpigmentation, and acne scars). Sure, the right skincare products are the first defense—an exfoliant, a brightening cream, and a vitamin C serum, for starters. However, even with consistent use of products that are regarded as high efficacy, it's possible a particularly stubborn spot will want to linger. That's when some people look to other remedies, like hydroquinone.
According to cosmetic and plastic surgeon David Shafer, "Hydroquinone is a chemical compound discovered in the early 1800s and was used in everything from skincare to photo developing. The chemical interacts with the melanin-producing cells in the skin, decreasing the production of pigment." While it can be effective at lightening dark spots on the skin, there's been some debate about hydroquinone's side effects. Is hydroquinone safe, and does it pose any risk? We tapped into three other pros in addition to Shafer to get the low-down: cosmetic dermatologist Ava Shamban, board-certified dermatologist Richard Bottiglione, and cosmetic chemist Ee Ting Ng.
Keep reading to learn all about hydroquinone's side effects and benefits.
Type of ingredient: Spot lightener.
Main benefits: Lightens hyperpigmentation and age spots, evens out skin tone.
Who should use it: In general, any skin type can use hydroquinone, however some skin may be sensitive to it.
How often can you use it: Hydroquinone can be used once nightly for three month stretches or until the skin has lightened up.
Works well with: Shamban explains that the classic formulation with the highest efficacy is 4% hydroquinone, .025% tretinoin, and a mild over-the-counter cortisone.
Don’t use with: Generally, hydroquinone is safe to use with most, if not all, ingredients.
What is Hydroquinone?
Also known as tocopheryl acetate, hydroquinone is found in skin-lightening creams, serums, cleansers, and moisturizers. "Hydroquinone is a topical skin treatment for melasma, freckles, age and sun spots, and even acne scars," Shafer says. "Used in combination with other acne products such as Retin-A, hydroquinone can help dramatically improve skin complexion." Shamban adds to this, reporting that hydroquinone can also be used to lighten up freckles as well as post-inflammatory hyperpigmentation, which is usually seen after an injury such as a burn or inflammatory acne.
Retin-A (tretinoin) is a form of vitamin A that helps the skin renew itself by encouraging cell turnover. It's commonly prescribed for acne, fine lines, and sun damaged skin.
While hydroquinone is effective at lightening spots, the results aren't immediate. It may take a matter of weeks (or months) before results are discernible to the naked eye. "Patients need to understand that the treatment is working at the cellular level to reduce the production of pigment," Shafer explains. "So the effects take several weeks to realize. As the old skin sheds and new skin is produced, the amount of pigment will be less, leading to a more even skin tone."
Benefits of Hydroquinone for Skin
Hydroquinone has several benefits for the skin.
- Lightens dark spots (hyperpigmentation): Hydroquinone is one of the most effective ingredients to lighten hyperpigmentation. "If you have dark areas from melasma, age spots, or brown spots left from acne, hydroquinone helps by decreasing the formation of melanin in the skin (the pigment in the skin that gives it a dark color)," says Buttiglione. Ng adds: "To date, hydroquinone is considered the topical gold standard in dermatology for reducing hyperpigmentation."
- Evens out skin tone: Because hydroquinone lightens certain areas of the skin that are darkened, the end result is a more balanced, even complexion.
- Treats melasma: "Hydroquinone serves as the backbone of any treatment for a wide variety of conditions, including melasma," notes Shamban. "Melasma, which is manifested by patches of darker skin typically on the forehead, cheeks, and upper lip, often runs in families and is triggered by UV and visible light exposure often in combination with hormonal shifts such as birth control pills, pregnancy or hormone replacement therapy." Hydroquinone can help rectify the side effects of melasma.
Side Effects of Hydroquinone
You may have heard some questionable things about hydroquinone—it's even been banned in the UK, Europe, Japan, and Australia. Still, Shamban maintains that though it has had a bad rap, hydroquinone is not dangerous. "It is approved by the FDA and there aren't any research studies or clinical evidence to suggest that there is any [human] harm to using hydroquinone," she says.
That said, something this potent doesn't come without side effects—"halo spots" around the treated areas being one of them. "The hydroquinone treats dark spots, but any product in contact with surrounding skin will also lighten those areas as well," says Shafer. "So the intended spot may be lightened, but the surrounding skin will also lighten compared to normal skin, and the area will appear like a light de-pigmented halo around the spot being treated."
If your skin skews sensitive, bear in mind that any topical cream is a potential allergen. "Hydroquinone frequently causes irritations like itchiness and redness in skins that are barrier-compromised or sensitive, which can be the case for any skin type," notes Ng. Shamban adds that "the most common side effects are irritation, redness, stinging, and inflammation."
How to Use It
"Over the years I have never found a more effective treatment for unwanted pigmentation than glycolic acid and hydroquinone," says Bottiglione. "I recommend using hydroquinone after cleansing the skin with a glycolic acid cleanser, like the Dermatologist's Choice pH Balanced Cleanser with Glycolic Acid ($25)," says Bottiglione. "The key is to eliminate excess oil, dirt, and makeup that can block the hydroquinone from entering the pores. The deeper the hydroquinone can penetrate into the skin, the better the benefits." And, while we all know the harmful effects of the sun on our skin, it can cause further darkening of spots, so using a UV-blocking sunscreen during the time you're using any hydroquinone product is a must.
"Most people don't need it all over the skin, just in particular areas," Bottiglione advises. "You should use it in the areas with hyperpigmentation." If you tend to be sensitive, Bottiglione recommends using it on alternating days, which can help the skin tolerate it better. "Using an over-the-counter option at a low concentration can help the skin tolerate it better as well," he notes.
Over-the-counter hydroquinone products are available at concentrations up to 2%. Anything higher than that requires a prescription. "I usually recommend evening before bedtime as I like to use the cellular regenerative hours overnight for the product to get to work," says Shamban. Also, Ng notes that hydroquinone makes skin more susceptible to UV damage and that insufficient sun protection during treatment can lead to the development of more hyperpigmentation—always ensure your skin is protected while donning a hydroquinone treatment.
The Best Products With Hydroquinone
Below, find our favorite hydroquinone products.
Shamban touts this as an excellent dark spot treatment. "With 2% hydroquinone among the heroes here, this serum improves overall skin tone, lightening and brightening dark spots and giving a fresh new even radiance," she says.
Alpha-hydroxy acids are a group of acid compounds, most often derived from plant-based sources. There are a variety of different ones out there, some of which include glycolic (derived from sugarcane) and lactic (derived from sour milk). While they all act on the surface of the skin as chemical exfoliants, they differ in size, and subsequently penetration and potency.
This derm-approved gel is lauded for its blend of hydroquinone and AHA's to help even out skin tone over time.
This product requires a prescription, as it contains a higher percentage of hydroquinone than the over-the-counter variety. "With 4% hydroquinone, this is effective with age spots and uneven texture as well as sallow yellow skin, hyperpigmented areas or spots, melasma, or erythema," says Shamban.
If you're struggling with residual dark spots from a breakout, Shafer recommends this serum only after the area has healed, followed up with an SPF.
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Cleveland Clinic. Hydroquinone skin cream, gel, emulsion, lotion, or solution.