Hydroquinone has become pretty controversial in the beauty world. One minute, it's the miracle ingredient for clearing up dark spots, and the next, it's supposedly carcinogenic. It's hard for anything to be deemed trustworthy and effective once labeled as a cancer causer. Yet, through all the fuss, experts have maintained that hydroquinone remains the gold standard for erasing hyperpigmentation and age spots. So in all that toxic talk, what's the truth? We asked three experts to weigh in.
Why all the fuss?
"Much of this controversy stems from its ban in South Africa due to side effects," explained Sejal Shah, NYC cosmetic dermatologist and founder of SmarterSkin Dermatology. "Subsequently, other countries banned hydroquinone. It turns out that the questionable products in South Africa contained mercury and other contaminants, which more likely account for side effects being seen."
Dr. Shah further explained that there have been reports of hydroquinone causing cancer in mice when administered in high doses orally, but there are no studies to date showing that this happens in humans and with a topical application. "When properly formulated and used, hydroquinone can be extremely safe and effective, and we have numerous studies confirming this," Shah added.
Does it bleach skin?
Rachel Roff, a medical esthetician and founder of Urban Skin Rx, quickly squashed this myth. "When used within a safe strength, hydroquinone doesn't bleach someone's natural skin tone. It evens out the skin," Roff said. While it may not be proven to cause cancer, if used incorrectly, it can leave skin vulnerable to excessive sun exposure, which could mean a higher risk of skin cancer and sunburn.
"As a general known fact, side effects of skin bleaching, regardless of product or ingredient, include skin irritation and sun sensitivity," dermatologist Dendy Engelman said. There's also a condition called ochronosis, where the skin darkens. This reaction is mainly associated with high concentrations of hydroquinone that has been used for prolonged periods of time.
When do you need hydroquinone?
The main purpose of hydroquinone in skin care is as a lightening agent. "Skin lightening is performed for a variety of reasons, including sun damage. Melanin (aka pigment) is produced by skin cells called melanocytes, and various topical creams are used to reduce the amount of pigment that is produced to brighten the skin," Engelman said. These include hydroquinone, which is the most common, botanical extracts, and antioxidants.
How do you use it safely?
A hydroquinone regimen should be used for no more than three to four months at a time, followed by a minimum of two months off. After the two months, if hyperpigmentation is still an issue, you can return to using hydroquinone for another three- to four-month period.
What if you just can't get behind hydroquinone?
While the experts agree that nothing works on dark spots quite as fast as hydroquinone does, there are ingredients that are just as effective. It may take longer to see results, but natural solutions like kojic acid, alpha arbutin, niacinamide, and vitamin C can help even out your skin. Something like SkinMedica Lytera 2.0, a pigment-correcting serum that is retinol- and hydroquinone-free, balances the skin's melanin production and resists triggers that cause discoloration.