Why You Should Avoid Hydroquinone Lightening Creams

Men and women worldwide use skin-lightening creams to reduce the appearance of age spots, dark patches, and acne scars. These products can also help you achieve a lighter skin color and even out your skin tone, but many formulas contain hydroquinone, mercury, or other potentially harmful ingredients, explains the UK's National Health Service. Some are available over the counter, but this doesn't mean they're safe.

According to Grand View Research, the global market for skin-lightening products was worth nearly $10 billion in 2021 — and its revenue will increase over the next five years. Skin-lightening creams, or bleaching creams, hold the largest market share due to their wide availability and ease of use. Their active ingredients inhibit certain enzymes and other compounds responsible for melanin production, notes a recent review published in Applied Sciences.

For example, hydroquinone works by suppressing tyrosinase, an enzyme involved in melanin synthesis. Melanin is the pigment that gives color to your skin and other tissues. People started using hydroquinone for skin whitening in the '60s when little was known about its side effects. Today, this ingredient is strictly regulated in most countries and cannot be used in cosmetic products.

Earlier this year, the U.S. Food and Drug Administration (FDA) issued a warning regarding the dangers of OTC hydroquinone lightening creams, saying they may cause a rare disease called ochronosis, among other adverse effects. But, like with most things, the research is mixed — and it's up to you as a consumer to make the right choice. 

The potential dangers of hydroquinone

Hydroquinone is a chemical compound that lightens the skin. Generally, it's prescribed for hyperpigmentation disorders, such as melasma, but it may also reduce the appearance of freckles and liver spots, says DermNet. In one study, this ingredient decreased pigmentation in 70% of patients with melasma in as little as three months. However, most countries, including the U.S., have banned its use in OTC bleaching creams and other cosmetics because of the potential side effects.

According to the FDA, hydroquinone may cause allergic reactions and permanent skin discoloration. There's also a risk of nail plate pigmentation, milia, and trimethylaminuria, a condition that gives your body a fishy odor, warns DermNet. This compound can also lead to ochronosis, a blue-black discoloration of the skin and other tissues, when used in large amounts for long periods.

Animal studies suggest a potential link between hydroquinone and cancer, but these findings may not apply to humans, according to clinical research presented in the journal Critical Reviews in Toxicology. However, this chemical can still put you at risk for eye disorders, irritant contact dermatitis, and other health conditions, warns a recent review featured in Applied Sciences. Plus, it may not be safe for pregnant women and those who are trying to conceive. 

Are there safer alternatives to hydroquinone skin-lightening creams?

Hydroquinone can be effective, but its risks may outweigh any potential benefits. "While it's a safe topical medication under the care of a dermatologist, unchecked use can lead to unnatural skin lightening and ochronosis, where the skin paradoxically turns darker permanently," said dermatologist Corey L. Hartman in an interview with The Washington Post. Also, DermNet warns that hydroquinone may be listed on product labels as quinol, tequinol, hydroquinol, hydrochinone, p-Diphenol, or 1,4-Benzenediol.

On the positive side, you can achieve a lighter complexion without resorting to hydroquinone bleaching creams. Dr. Hartman recommends choosing a product that contains cysteamine, a metabolite of the amino acid l-cysteine. This non-toxic ingredient reduces hyperpigmentation and can even out your skin tone. Alternatively, you could try a cream with azelaic acid, retinoids, or niacinamide, which appear to be safer than hydroquinone, suggests a recent report published in Pigment Cell & Melanoma Research.

For example, azelaic acid works similarly to hydroquinone, but it doesn't cause ochronosis — even when used for long periods. In clinical trials, skin-lightening creams with 20% azelaic acid were just as effective as those containing 4% hydroquinone and more effective than 2% hydroquinone creams, according to the above review. 

Another option is glutathione, an antioxidant that can moderately lighten the skin and minimize dark spots. Microneedling, laser therapy, and chemical peels can reduce hyperpigmentation, too, but they may cause scarring, inflammation, and other adverse reactions.