Posts Tagged ‘hydroquinone’
Hydroquinone has been the gold standard for treating hyperpigmentation for over 50 years, but some confusion about hydroquinone has developed over the past few years. Common rumors include, hydroquinone has been banned or that it causes cancer. A lot of information found on the internet misrepresents hydroquinone by omitting some of the facts related to Hydroquinone studies and the FDA’s proposed rule.
I personally use hydroquinone on my skin to treat melasma and hyperpigmentation. I love what hydroquinone does for my skin and I have not been able to duplicate the results with other skin lighteners, however health is always going to outweigh the benefit of beautiful skin. I certainly would not want to use anything that is unsafe, furthermore I consider my self an advocate for my clients. It is important that my clients feel confidant in my knowledge of skin care and even more important that they trust that I always have their best interest in mind. I have spent a lot of time educating my self on hydroquinone and I aim to clarify some of the confusion.
What is Hydroquinone
Hydroquinone is an active ingredient used in topical creams and cosmetics as a depigmenting agent to treat skin discoloration such as melasma. Topical skin lightening creams containing Hydroquinone first became available in the United States in 1955. Hydroquinone has been described as a ubiquitous chemical, meaning it is something that we are exposed to as part of our daily life. Hydroquinone occurs in some plants as free hydroquinone or as arbutin. Arbutin (glucosylated hydroquinone) is found in the leaves and fruits of many plants that are used for food and bacteria in the intestines can transform it into hydroquinone. Hydroquinone and Arbutin can be found in foods such as cranberries, blueberries, pears, beans, broccoli, onions tea, coffee, beer, red wine, all-wheat bread and cereals (concentration may exceed 1%). Hydroquinone also has a number of other uses, it is used as an antioxidant for rubber, a reducing agent for photographic developing solutions, a stabalizer in paints and varnishes. It is also found in hair dyes and nail polish. The list goes on and on.
Does Hydroquinone Cause Cancer
Hydroquinone has been available as active ingredient for over 50 years and there have not been any reported cases of hydroquinone induced cancer in humans. There is also no evidence in human clinical studies to suggest that Hydroquinone could cause cancer in humans. It is suggested that additional studies are needed.
What about the Rats? I have heard and read many times that hydroquinone causes cancer in rats, so I decided to read the study and reviews myself. The 2 year gavage study with hydroquinone, showed some Rats with end stage CPN developed cancer. The problem is that you need to read the full report and it’s reviews before you develop a conclusion. CPN is a renal disease that affects various strain of rats, but has no counterpart in humans. In a 2007 review, McGregor concluded that hydroquinone is carcinogenic only in the context of end-stage CPN, which is not relevant in humans. There is some debate over using rats in carcinogenicity studies, as test results may not be relevant to humans. It should be noted that certain strain of rats are prone to spontaneously develop tumors.
Does Hydroquinone Cause Ochronosis
There are two types of ochronosis, endogenous and exogenous. It is only exogenous ochronosis which can be induced by the topical application of compounds including hydroquinone as well as antimalarias, mercury, resorcinol and phenol. Exogenous ochronosis is a fairly rare type of dermatitis that needs to be diagnosed by a dermatologist. It is not known exactly how hydroquinone induces ochronosis but suggested factors include: sun exposre, long term use of hydroquinone, high concentrations of hydroquinone, other active derivatives and penetrating vehicles such as t-butyl alcohol, mercuric compounds, resorcinol and hydroalcoholic lotion. Exogenous ochronosis is believed to be a progressive disorder that likely develops over several years.
Was Hydroquinone Banned
No, hydroquinone was not “banned” in the US. Hydroquinone is available in concentrations of 2% or less over the counter (OTC), and concentrations over 2% (typically 4%) are available in prescription strength in the United States.
To simply say Hydroquinone has been “banned” in other countries is something of a misrepresentation. First, we need to acknowledge that hydroquinone is an active ingredient available in prescription strength and over the counter (OTC) strength. I am not aware of any ban or proposed ban on prescription strength hydroquinone in any country. The confusion seems to come from the change in availability of over the counter (OTC) hydroquinone. In Japan and Australia hydroquinone is no longer available in cosmetics OTC (over the counter), it is only available as a prescription based ingredient.
As part of a review of OTC products, the FDA published a proposed rule in 2006 to consider the withdraw of the 1982 rule that recommended hydroquinone be GRASE, because of evidence indicating that hydroquinone may act as a carcinogen in rats and mice after oral administration. It is argued that this is not relevant in humans, so the proposed rule recommended additional studies should be conducted to determine if there is a risk to humans. The FDA has yet to make a final ruling, but until then it’s still believed that hydroquinone should remain available as an OTC (over the counter) drug product.
I have considered the facts, studies, reviews and opinions of medical professionals and have concluded that I will continue to use hydroquinone. I would not be concerned if my mom, best friend, husband or children were using hydroquinone. I feel very confidant in the efficacy and safety of hydroquinone. I will continue review and consider any new information and I will modify this post if my opinion changes.
I have read hundreds of pages of studies, reviews, letters and other published literature on the subject of hydroquinone. I am not able to share everything I have learned, but I focused on some of the main points. I have included links to resources that are available on line, I encourage anyone who is concerned about hydroquinone to do thier own homework. I also recommend consulting with your doctor.
If you are using hydroquinone, be sure to use a broad spectrum sunblock and give your skin a resting period from hydroquinone. For example: 3 months on and 3 months off.
There have been reports of counterfeit beauty products and illegally imported skin care products containing mercury. I strongly discourage purchasing skin bleaching creams on-line.
Nomination Profile /Hydroquinone [CAS 123-31-9] Supporting Information for Toxicological Evaluation by the National Toxicology Program /21 May 2009 / Prepared by U.S. Food & Drug Administration Department of Health and Human Services
Hydroquinone: An Evaluation of the Human Risks from its Carcinogenic and Mutagenic Properties / Critical Reviews in Toxicology 2007, Vol. 37, No. 10 , Pages 887-914 / Douglas McGregor /Toxicity Evaluation Consultants, Aberdour, Scotland, United Kingdom / Toxicity Evaluation Consultants, 38 Shore Road, Aberdour, KY30TU, Scotland, UK
®© All Rights Reserved.
Melasma (chloasma) is hyperpigmentation or dark, irregular patches commonly found on the upper cheeks, nose, upper lip, and forehead. The patches can develop gradually over time or during pregnancy. Melasma can also develop when taking oral contraceptives or hormone replacement therapy medications. Melasma is thought to be stimulated by hormones, however exactly which hormones are involved has yet to be determined. The most important factor in the development of melasma is sun exposure,and without the strict avoidance of sun exposure, treatments for melasma are likely to be unsuccessful. Melasma can be permanent or disappear and reappear with each pregnancy.
Hyperpigmentation is the term used to describe any type of abnormal dark area of the skin, this includes melasma, freckles and sun spots. When we treat hyperpigmentation in the skin, it is important to understand that the melanocyte is not functioning properly, so it overproduces melanosomes and the excess melanin can not be evenly distributed among the keratinocytys. As the cells rise to the surface of the skin they cause over pigmented or dark spots. When the skin is exfoliated with AHA’s, chemical peels or microdermabrasion, the hyperpigmentation will appear lighter because some of the top layers of skin have been removed and the pigment is less dense (temporarily). The pigment is still there, it is just appears lighter and the melanocyte is still not functioning properlly, so in a few weeks as the top skin layers are replaced the pigment will appear dark again. Tanning will also further stimulate the melanocyte causing darker pigmentation to develop and Melasma will become worse. Hydroquinone works to suppress the melanocyte and is an excellent way to treat the pregnancy mask. For best results Hydroquinone can be used in conjunction with exfoliating treatments. I understand this description may be a little difficult to understand, so if I have lost you, you can come in for a consultation and I will use visual aids to better explain the cause and treatment for hyperpigmentation.
Melasma: My Personal Story
I have Melasma myself, on my upper cheeks and forehead. I first developed Melasma patches on my upper cheeks in my late twenties and later after giving birth to my second child I developed another large patch in the center of my forehead. I have successfully treated my Melasma, but I need to continue to maintain my skin so that it doesn’t come back. As a Medical Esthetician, I obviously have access to the best skin care products and treatments available. I can share both my professional and personal experience with treating Melasma. Using hydroquinone, and broad spectrum sunblock is absolutely necessary for treating and controlling Melasma. Even after successful correction of Melasma, the hyperpigmentation can reappear especially after sun exposure.
My Personal Skin Regimen
My personal skin regimen includes using the Obagi Nu-Derm system, with a 1/2 gram of Clear (4% hydroquinone) AM and PM. Initially I used a 1/2 gram of a .1% tretinoin ( Retin-A) every night, however I am now on a maintenance protocol and only use tretinoin occasionally. I also use a topical vitamin C and a broad spectrum sunblock containing Zinc oxide. I top it off with Jane Iredale mineral makeup SPF 20.
Professional Skin Treatments
I have had an Obagi Blue Peel, and Fraxel treatments. I personally felt I had better results with the Blue Peel. Fractional laser resurfacing and Blue Peels are ideal when treating deep or resistant Melasma.
Although I have corrected my Melasma, I still need to continue to maintain my skin to keep the Melasma under control. In addition to the topical products I previously mentioned, I try to have a light chemical peel every 4-6 weeks. The chemical peel I have found that gives me the best results treating pigmentation, is a custom chemical peel.
Obagi Nu-Derm System
This is correction after using the Obagi Nu-Derm System. This is a prescription strength skin system and is only available at medical skin clinics. Treatment protocols vary depending on skin type and condition.
Obagi Blue Peel
This is an example of deeply pigmented Melasma.
After treatment with Obagi Nu- Derm & Obagi Blue Peel
It is important to precondition with the Obagi Nu-Derm System and Retin-A before having a Blue Peel. I recommend preconditioning for a minimum of 6 weeks or longer depending on how aggressively Tretinoin is used. Patients that are better preconditioned get a better result. It is also necessary to continue to use the creams after peel to prevent Hyperpigmentation & to maintain healthy skin.
Custom Chemical Peel for Melasma
The Custom Chemical Peel I use is a light peel that can be repeated as often as every 4-6 weeks, compared to the Obagi Blue Peel which is a deeper peel necessary for treating deeper pigmentation. I have decided to not include details of my protocol for this custom peel. It is proprietary information that I don’t wish to share with others in the industry. If you would like to learn more, you can schedule a private consultation. I can tell you that with this peel, I will usually get light peeling for 2-3 days. The peeling is minimal and I would not consider there to be any “down-time”, you can still go about your regular routine. You just don’t want to schedule a peel less than a week before any major event like a wedding. I make it a point to work with my clients and their social calendar, so that they look their best for any events.
Get Professional Treatment For Melasma
If you have Melasma call to schedule a free consultation at
Paradise Valley Skin Klinic.
There are many people that have embraced their freckles and love them, while others would prefer spotless skin.
Freckles are clusters of concentrated melanin, ranging in color from red, tan and brown. Some people have a genetic tendency to develop freckles, however sun exposure is the main cause of freckles. Freckles generally appear on sun-exposed areas, and will appear darker or more prominent after sun exposure. Ephelides is a freckle which is flat, light brown or red, and fades when protected from UV light. Ephelides are more common in those with light complexions. Liver spots (also known as sun spots and Lentigines) are freckles that develop after years of sun exposure, and are more prominent with age.
If You Want To Remove Freckles
The best way to remove freckles is to have a series of photofacial treatments, combined with bleaching creams containing 4% hydroquinone and tretinoin (Retin-A). A good UVA/UVB sunblock is also recommended, because UV exposure will make freckles more prominent.
Photafacial (Fotofacial) uses IPL (Intense Pulse Light) to treat skin discoloration, redness and broken capillaries. There generally isn’t any down time associated with IPL treatments, however pigmented spots will appear darker temporarily. After a photofacial any freckles or pigmented lesions will darken up and flake off. It can take up to two weeks for spots to flake off. The number of treatments needed will vary depending on the skin condition.
If You Like Your Freckles
If you are not concerned with removing freckles you can use lightening and brightening products. These products brighten the skin without removing freckles. Freckles will fade slightly, but will not go away.
OBAGI C-RX System
If you love your freckles, you may want to skip the Therapy Night Cream from this system. The Therapy Night cream has a 4% hydroquinone, which will further fade freckles and pigmentation. The Clarifying Serum also has a 4% hydroquinone, however this C- serum is only used in the morning and is not enough to eliminate freckles. The Clarifying Serum is great for anyone that wants brighten their skin tone, and still keep their freckles.
iS Clinical White Lightening Complex
Brightens and lightens skin with beneficial moisturizing properties. Utilizing an innovative blend of proprietary lightening ingredients and pharmaceutical-grade botanicals, this high performance formula exfoliates, reduces inflammation, and provides strong antioxidant protection.
White Lightening Complex will brighten the skin, and freckles will fade, but not go away completely.
To prevent freckles, you need to use a good sunblock. I recommend a UVA/ UVB sunblock with an SPF 30 or higher. I also recommend sunblocks with Zinc, because it is a broad band physical block. SPF only measure UVB protection, and even if a product is labeled to have UVA protection, it may not protect from the full UVA spectrum. Topical Vitamin C ( L- ascorbic acid) can also help prevent sun damage because it neutralizes UV radiation.
After Obagi Most Women Go Naked
The Obagi Nu-Derm® system is the world’s #1 professional skincare program, used by more than 11,000 physicians throughout the world. It is the most effective treatment for skin health restoration, correcting complex problems such as acne, melasma (brown spots), fine lines, wrinkles, and scars.
The Obagi Nu-Derm System contains prescription-strength formulations that can only be sold through a licensed physician, such as a dermatologist or plastic surgeon.
*Take a moment to watch the Obagi video at the end of this post.
The goal of the Obagi Nu-Derm system is to create soft, radiant- looking skin, increase skin tolerance and restore normal skin functions. The problem is, it only works if you use it. It works even better when you use it correctly. Dr Zein Obagi created the Obagi Nu-Derm as a skin health restoration system, and the products are designed to be used together. Each of the products are good individually, but if you don’t use the full system, you will not see the amazing results that Obagi is famous for.
- Increase smoothness
- Reduce pore size
- Improve elasticity
- Normalize oil production
- Increase skins own ability to hold moisture
- Increase skin tolerance to all external factors
- Generate a balanced, even skin tone
- Reduce hyperpigmentation ( freckles, age spots, melasma, Post inflammatory hyperpigmentation )
I have worked professionally with the Obagi products for over 10 years, and have had “literally” thousands of clients on the Nu -Derm system. The results shown in the before and after photo’s are typical and common. If you use the Obagi system correctly you will experience skin transformation. Using a specific dose and frequency that’s recommended specifically by your skin care professional for your skin condition, the prescription-strength system exfoliates old skin leaving healthy, new skin that looks and acts younger and healthier. The products in the Nu-Derm System are clinically proven, prescription-strength, ingredients that work to improve your skin cell function, compared to retail products that contain more cosmetic-based ingredients.
Obagi System: Steps 1-6
All of the products are labeled AM, PM or both AM/PM and numbered 1-6 in the order you would use them. The lines between the letters in the word OBAGI are designed as a tool to measure product. For example from the O-A = 1/2 gram ( thick like toothpaste).
Step #1 Cleanser AM/PM
Foaming Gel – For Normal/Oily Skin or Gentle Cleanser – For Normal/Dry Skin
Proper cleansing is necessary
Step #2 Toner AM/PM
Adjusts the pH of the skin for increased penetration of the system ingredients.
Exfoderm® Forte – For Normal/Oily Skin
An alpha hydroxy acid (6% glycolic acid, 4% lactic acid) that removes old skin cells while promoting new skin cells for a lighter, brighter, firmer complexion for skin that needs deeper exfoliation.
Step #5 Bleander & Tretinoin PM (mixed as prescribed)
This step restores damage to the deeper layers of the skin. It restores skin elasticity by enhancing the production of collagen and elastin.
A topical prescription treatment that contains 4% hydroquinone to target hyperpigmented (discolored) areas of the skin and increase the penetration of the active ingredients of the system.
Tretinoin Cream 0.025%, .05% , or.1% (as prescribed)
A topical prescription, use as directed. *Do not wax skin that is treated with tretinoin.
Step #6 Healthy Skin Protection SPF 35 AM
A sunscreen with 9% micronized zinc oxide and 7.5% octinoxate that helps to protect newly transformed, younger looking skin and prevents further sun damage. This is a physical/chemical sunscreen with UVA/UVB protection.
If you just want to FEEL good you should get a spa treatment. If you want to LOOK good, then follow the recommended Obagi Nu Derm protocol. Generally, with a more aggressive protocol you will have more reaction, however you will also have more stimulation, see correction faster and build up tolerance more quickly. That doesn’t mean everyone should start out aggressively, individual system protocol is determined by skin type.
Reaction Phase: Out with the Old
Inital correction and stimulation phase
This is the time in which the damaged top layer of skin is replaced by a new layer of healthier cells. It takes about six weeks for ” newborn” cell to reach the surface of the skin and exfoliate.
You WILL experience one or more of the following symptoms:
- Dryness – Itching
- Burning – Redness
- Sensitive skin
- Exfoliation ( flaking and peeling)
These reactions are a sign the skin restoration is in process. The Nu- Derm system is accelerating the skin cell turnover to alter the rough top layer of the skin.
Tolerance Phase: In with the New
Correction and stimulation continues
Your skin has built tolerance , skin improvement is viable. The skin increases the production of collagen and elastin, to diminish wrinkles and reduce pore size.
Correction Phase: Healthy Glow
Finally, your skin enters the last stage and you are ready for a maintenance protocol. Skin tolerance is now complete.
“Begin with the end in mind.” – The 7 Habits of Highly Effective People
Peeling is more severe in the center of the face and around mucus membranes (eyes, nose and mouth). You can try focusing product use on the forehead and cheeks and blending them in toward the center of the face. Most people notice that the peeling reaction peeks late afternoon-early evening. It is okay to cleanse your face later in the day ( at least 4 or 5 hours later) and reapply sunscreen and makeup. Cleansing the skin can help slough off some of the loose peeling skin. If you have an social event and need to stop reactions, discontinue step 5, four days before event. Obagi Action and Tolereen are “control” products that can be used as needed to relieve surface tightness, itching and dryness. Control products should only be used temporarily, as they slow the skin restoration process. Be sure to discuss options for controlling your reactions with your skin care professional.
Obagi Nu-Derm Action
A moisturizing cream to be used as needed to soothe areas of dry, flaky skin.
Obagi Nu-Derm Tolereen
Contains 0.5% hydrocortisone for the temporary relief of itching and burning associated with minor skin irritations.
Find Obagi neer you. www.obagi.com