Hydroquinone 4 cream

Are bleaching creams safe? 

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Many of my patients are concerned about Hydroquinone 4 cream , in which patches of skin become darker. I often treat this problem with lightening creams that contain a hydroquinone. I am sometimes asked “are bleaching creams safe?” and I think a discussion of the risks and benefits of bleaching creams that contain hydroquinone is important.

What is hydroquinone?
Hydroquinone is found naturally in foods such as berries and coffee. It blocks the skin’s production of pigment (melanin) and is considered to be the ‘gold standard’ in treating hyperpigmentation.

In Canada, hydroquinone is found in over-the-counter lightening creams in concentrations of up to 4% (in the US concentrations above 2% are by prescription), and stronger preparations can be prepared by pharmacists. Hydroquinone is often combined with other lightening ingredients such as tretinoin, kojic acid and vitamin C.

What are bleaching creams used for?
Hydroquinone is used to treat many causes of uneven pigmentation including:

Melasma: hormone-induced pigmentation that results in brown patches, most commonly seen on the face in women
Solar lentigines (“sun spots”): benign brown spots caused by sun exposure
Post-inflammatory hyperpigmentation: discolouration that sometimes results after the skin has been inflamed, most commonly in individuals with darker skin tones