Understanding Hydroquinone (HQ)
Hydroquinone is typically applied topically as a prescribed cream. It is used to lighten areas of darkened skin, such as freckles, age spots, chloasma, melasma, and stubborn pigmentation caused by pregnancy, hormones, or skin injury. By decreasing melanin production, Hydroquinone effectively targets and reduces hyperpigmentation.
Why Is Hydroquinone Controversial?
Hydroquinone has sparked significant controversy over the years, leading to bans in some countries. Its effectiveness as a treatment for stubborn hyperpigmentation is undeniable, making it the gold standard in many dermatological practices. However, the phrase "too much of a good thing can be a bad thing" applies here. Overuse and misuse of Hydroquinone have led to severe side effects, which in some cases are irreversible.
The Benefits of Hydroquinone
When used correctly under medical supervision, Hydroquinone delivers spectacular results. Doctors who prescribe the correct dosages and application periods can help patients achieve significant improvement in their skin condition. Compliance with medical guidance ensures that the skin is managed safely, resulting in successful outcomes for both doctors and patients.
The Risks of Hydroquinone
Problems arise when Hydroquinone is used in high concentrations, too frequently, or for prolonged periods without medical supervision. Continuous, unmonitored use can lead to depigmentation (loss of pigment) and skin damage. Hydroquinone should be used for a maximum of three months at a time, with breaks in between to allow the skin to adjust.
The Potential Dangers of Misuse
Uncontrolled use of Hydroquinone can result in prolonged redness, sensitivity, extreme dryness, and hypopigmentation (loss of pigment). In severe cases, a condition called ochronosis can develop, characterised by papules (pimples and breakouts) and dark, bluish-black pigmentation. This condition is extremely difficult to treat or reverse.
Due to the extensive damage caused by past misuse, Hydroquinone has earned a bad reputation and remains banned in some countries. However, in South Africa, it is still available by prescription, though doctors are cautious about prescribing it. While controlled usage periods can yield excellent results without harmful side effects, the history of Hydroquinone misuse continues to overshadow its potential benefits.
