Hyperpigmentation (darker areas of skin, sun spots, melasma, residual acne scars) is typically the most common skin complaint. In other parts of the world, lighter skin is highly revered and there are a multitude of products that promote skin lightening abilities. Hydroquinone (often seen in products as “HQ”) is quite effective, but has been the subject of some debate over the last few years. Hydroquinone is the only FDA-approved skin-lightening ingredient in the US and it works by turning off the cells that produce melanin. It is available in over-the-counter products in concentrations up to 2%, but higher concentrations require a prescription. Some prescription creams combine hydroquinone with tretinoin (Vitamin A) to combat melasma, a skin darkening condition that can be caused by pregnancy or extended over-exposure to the sun.
In lab mice with extremely concentrated internal exposure, HQ was linked to cancer. In a topical product, research suggests that hydroquinone’s reach is very specific to the cells that produce pigment, called melanocytes, and has not been linked to cancer in humans. It is important to understand the science behind this ingredient to feel comfortable with its use and benefits. Physicians will prescribe its use to effectively reduce pigment for a specific period of time then recommend other non-hydroquinone products for long-term use. Other lightening ingredients include kojic acid (derived from mushrooms), azaleic acid (derived from berries) and licorice root. Chemical peels (in lighter-complexioned patients) can be highly effective. It is imperative that you wear a broad spectrum SPF 30+ every day, especially when trying to reduce unwanted pigmentation.
Dr. Hurvitz is happy to discuss hyperpigmentation options that are right for you.