Why Dermatologists Recommend Hydroquinone to Correct Hyperpigmentation

Dark marks — like sun spots and melasma — can be notoriously difficult to treat. For decades, dermatologists, including Dr. Sandra Lee (aka Dr. Pimple Popper) have been relying on hydroquinone to manage many types of hyperpigmentation. Here’s why.

Hyperpigmentation that can be treated by a dermatologist with hydroquinone

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What is hydroquinone?

First used in photography developing solutions, hydroquinone is a white, granular organic compound — meaning it contains the element carbon. Though it’s been around since the 1800s, hydroquinone’s skin lightening properties were discovered accidentally — when a group of leather tannery workers in the 1930s began noticing depigmented patches (known as leukoderma) on their hands and forearms. Turns out, the gloves they were wearing were made with a version of hydroquinone.

Over subsequent decades, various preparations of hydroquinone were studied in both animals and humans. The compound was found to be reasonably safe and effective for reducing hyperpigmentation.

How does hydroquinone work?

A common misconception about hydroquinone is that it bleaches skin — but that’s not technically correct. The compound affects melanocytes, the skin cells responsible for producing pigment. Here’s how:

  • Decreases number of melanosomes, the “packages” inside melanocytes that contain melanin
  • Inhibits tyrosinase, the enzyme that helps catalyze melanin production

Because hydroquinone isn’t actually bleaching your skin — but instead is just hindering its ability to produce pigment — it makes sense that its effects last only as long as you’re applying the ingredient. Once you stop using hydroquinone, your skin reverts to normal melanin production.

What skin conditions does hydroquinone treat?

For decades, dermatologists have relied on hydroquinone to treat a variety of skin concerns under the umbrella of dyschromia — meaning patches of skin discoloration. This includes:

Hydroquinone is particularly valued by dermatologists for its ability to treat more stubborn types of pigmentation, like melasma, which is most often caused by UV damage or hormonal changes.

Does hydroquinone have side effects?

In recent years there has been some controversy surrounding hydroquinone, but there has been much evidence showing that the compound — when used as directed — is safe for the vast majority of patients. Most typically, concentrations of less than 4% have very mild reactions, including:

  • Dryness
  • Redness
  • Irritation
  • Inflammation

More serious complications are documented, but extremely rare in the U.S. Out of millions of hydroquinone users, only 22 have experienced a condition called exogenous ochronosis, which results in bluish-black spots on the skin.

To minimize any potential complications, dermatologists typically suggest that patients use hydroquinone for no more than three months at a time. If no improvement is seen, discontinue use. If the product does work for you, it’s generally regarded as safe to wait several months and resume treatment as needed.

Dark Spot fix with hydroquinone for hyperpigmentation by SLMD Skincare

Can you find hydroquinone without a prescription?

In the U.S., hydroquinone is primarily available by prescription, but you can still find it over-the-counter. SLMD Skincare Dark Spot Fix is a blend of hydroquinone, salicylic acid, kojic acid and niacinamide to exfoliate, fade hyperpigmentation, and support the skin barrier. According to Dr. Lee, the combination of hydroquinone and retinol is still the dermatological gold standard for treating hyperpigmentation in patients with a variety of skin types and tones.

Dr. Lee’s last word

Hydroquinone is extremely effective in treating hyperpigmentation. It works by inhibiting the production of melanin in the skin, which helps prevent dark patches from forming. Now when we combine that with exfoliants and retinoids, we have a potent combination that both prevents and treats those stubborn dark marks.

—Dr. Sandra Lee


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