Skin lightening, or skin bleaching, is a cosmetic procedure that aims to lighten dark areas of skin or achieve a generally paler skin tone. It’s usually used to improve the appearance of dark patches such as melasma and hyperpigmentation. The main product currently used to lighten the skin is an ingredient called Hydroquinone.
Skin-lightening procedures work by reducing the concentration or production of melanin in the skin. Melanin is the pigment that gives skin its colour and helps protect it from the sun.
What is Hydroquinone?
Hydroquinone is the most commonly used pigment inhibitor and is often the primary treatment option for post-inflammatory hyperpigmentation and melasma. It works by inhibiting the body’s ‘tyrosinase’, an enzyme necessary to produce melanin, but it may also alter the formation of melanosomes and selectively damage melanosomes and melanocytes.
Is Hydroquinone Safe?
Although considered effective, it commonly causes skin irritation and may have a cytotoxic effect on melanocytes and cell DNA. In 1994, the Journal of the American College of Toxicology (now known as the International Journal of Toxicology) published a conclusion that stated that “hydroquinone is a potent cytotoxic agent that causes mutations and alterations to DNA, and that it should not be used in any leave-on type of product; it is safe for rinse-off products when used in concentrations less than 1%.”
Concern over cytotoxicity has resulted in the banning of Hydroquinone from use in skin products in some countries. Unfortunately, many hydroquinone-containing products remain on the market to this day. In 2007, the FDA reported its intent toward banning the use of hydroquinone in non-prescription products due to safety issues but has not implemented any new regulations.
Hydroquinone is currently banned in the UK unless prescribed by a doctor. This is because it can cause serious side effects if used incorrectly.
Potential Side Effects
Used in reasonable concentrations and under doctor supervision, hydroquinone can be safe and effective.
However, some patients continue hydroquinone treatment for years without medical supervision. This is dangerous and can result in severe consequences that are difficult to reverse.
The most common side effects of using Hydroquinone are:
- Patchy Skin
Sometimes referred to as ‘Halo spots’ – as the hydroquinone treats dark spots, any product in contact with surrounding skin will also lighten those areas as well. 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.
- Darkening of Skin (Ochronosis)
Ochronosis is also a common risk when hydroquinone is misused. According to research, ochranonsis is a condition that might occur following long-term application of skin-lightening creams containing hydroquinone. Ochranosis may cause darkening of the skin, instead of fading a particular spot. Long-term use of Hydroquinone creams may also lead to exogenous ochronotic lesions. The duration of use is directly proportional to the risk of developing the condition, with most cases occurring after years of use.
If you already have sensitive skin, 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. The most common side effects are irritation, redness, stinging, and inflammation.
Any condition causing redness and inflammation can enhance the discolouring effects of UV exposure, including overuse of hydroquinone.
We now know that decreasing the amount of melanin in the skin, as hydroquinone does, creates photosensitivity. Without proper sunscreen use (SPF ≥30, with frequent reapplication), photosensitivity leads to inflammation which stimulates melanin production.
Alternatives to hydroquinone
Non-hydroquinone brightening agents can be prescribed instead of hydroquinone as a healthy maintenance system and to avoid atrophy, carcinogenesis, and other side effects associated with Hydroquinone use.
At Health & Aesthetics, we use non-hydroquinone protocols—designed not to bleach, but to stabilise cells to stop the melanocytes from being active all the time.
Brightalive uses multi-vectored skin brightening approach to minimise the appearance of spots and uneven skin tone, while preventing new pigmentation from forming. Formulated with the exclusive ZOX12™ slow-release antioxidant complex, liquorice root, natural enzymes, and ultra-stable vitamin C. Mild enough for everyday use.
A retinol-based solution clinically proven to rapidly improve the appearance of uneven skin tone for a brighter, clearer, and smoother complexion. It promotes exfoliation to eliminate uneven skin tone and improve skin smoothness and supports skin’s resiliency against future discolouration aggressors. It is specially encapsulated to deliver a targeted, controlled release of retinol for maximized brightening as well as containing calming + soothing properties.
Daily Power Defense is formulated with ultrasomes and roxisomes enzymes that initiate and speed DNA repair to enhance skin’s natural healing mechanism and protect against oxidative damage. Ceramides help restore lipid balance and strengthen the skin barrier system, while low-concentration retinol stimulates epidermal renewal and collagen production.
Cosmelan regulates the melanin activity, causing the pigment-producing cells to slow down their abnormal over-production and function in a more uniform way.
Cosmelan is formulated without Hydroquinone. Active ingredients include azelaic acid, kojic acid, arbutine, phytic acid, ascorbic acid. Cosmelan® Depigmentation treatment action mechanism is based on the inhibition of tyrosinase, a basic enzyme in the melanin formation process. Several of the substances present in the Cosmelan formula act by blocking this enzyme.
Sun protection is vital in any regime but especially important for those seeking to treat pigmentation as this activates the melanocytes which increase melanin production – the thing you are trying to stop. We always suggest a broad-spectrum SPF of 30 or above.
Contains fractionated melanin and antioxidants to shield skin from high-energy, blue-violet light.