First, the Food and Drug Administration restricted use of mercury as a lightening agent because of its caustic heath influences. Now, hydroquinone could face similar cosmetic prohibitions. But is the FDA's recent finding of hydroquinone as generally unsafe and not effective justified$%: Dermatologists and researchers have posted passionate views about the need to keep hydroquinone on the market as a skin lightener or as a minimum, allow it to remain available via prescription.
While such views abound, the question remains: Has the United States just lagged behind an international trend of banning potentially dangerous cosmetics and is now starting to catch up$%: Or, is hydroquinone still a safe skin lightening agent when used properly$%:
For years, consumers have used cosmetics containing hydroquinone for issues like melasma, also known as the "mask of pregnancy", age spots and acne scarring. As a skin lightener, hydroquinone hampers the production of the production of melanin, the pigment that gives the skin its color.
A recent medical review of hydroquinone published in the Journal of the European Academy of Dermatology and Venereology, concluded that doctors should recommend hydroquinone cautiously because of its potential, yet undocumented, ability to cause DNA damage and cancer in humans. However, such findings have not swayed medical professionals' confidence in the safety and effectiveness of hydroquinone.
In an interview with Skin and Allergy News, Dr. Valerie Callender, a dermatologist in private practice in Mitchellville, Maryland, said that it would be "ridiculous" to suggest that animal data could be used to raise concerns about human carcinogenicity. Yet, animal testing is generally the first step in determining if a new drug is safe for human consumption in clinical trials.
Even dermatologist Susan Taylor, M.D., assistant professor of dermatology at Columbia University, New York finds the link between hydroquinone and cancer dubious. Dr. Taylor reported in Dermatology Times, "If you give a rat enough of anything orally it may well develop cancer."
Besides cancer, ochronosis has surfaced as another side effect of hydroquinone usage. Ochronosis describes the darkened skin than can results from use of skin creams containing hydroquinone. Ochronosis has been largely documented in countries like Senegal, South Africa, Saudi Arabia and Nigeria where as much as 25% of the adult population may use skin lightening agents.
Reports in medical periodicals like the Journal of Dermatological Treatment and the American Journal of Clinical Dermatology link the preponderance of ochronosis to application of excessive amounts of hydroquinone and combining hydroquinone with chemical agents like mercury, phenols and potent acids.
Regardless of the battles over the relevance of medical studies on hydroquinone, the FDA faces heated arguments to banning hydroquinone usage. Medical associations like the American Academy of Dermatology asked its members to contest the proposed ban on hydroquinone by submitting their personal accounts of their experience with using hydroquinone on patients to the FDA for consideration.
While the FDA deliberates over the safety of hydroquinone, consumers still have multiple skin lightening options. Since hydroquinone was first classified as generally safe and effective in 1982, new chemicals and botanical ingredients have entered onto the scene as alternative skin lightening agents.
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