At PCA SKIN® we pride ourselves on being a reliable educational resource to both clinicians and consumers. Skin health professionals come to us with questions – even if they don’t carry our products – because they know we are able to sift out the noise and hype surrounding the skin health industry. This blog will be a little longer than most, because the subject and confusion surrounding the use of hydroquinone (HQ) remains constant, and we hope to give you information to educate both you and your patients.
Hydroquinone (HQ) has been used in the cosmetic industry ever since it was first discovered during World War II. In September of 1982, the FDA stated within their monograph that HQ was deemed safe to use for three months. There are no specifics as to why, other than if there were positive results, then they would be obtained by the end of the three month increment.
Now, to define a couple of terms, “monograph” is in essence a “rule book” that the FDA utilizes for drug ingredients that are available to the consumer – these are called “over-the-counter drugs” or “OTC.” In lower percentages, many drugs are available to consumers OTC, such as hydrocortisone, salicylic acid and HQ, to name a few. These monographs are put into place to keep consumers safe when using ingredients outside of a physician’s care that are considered to be a drug.
In 2006, the 1982 monograph was withdrawn and there currently is no monograph for HQ. So far, studies have been conducted only on the safety of orally administered, high doses of HQ in male and female rats, and female mice over extended periods of time. It was determined that more studies needed to be performed. Clearly, this is not how HQ is used in the skin health industry.
Today, we must follow the original 1982 monograph until there is another in place. That being said, PCA SKIN has one OTC HQ product for daily care use – Pigment Gel®. This is a formulation with a blend – much different from using a single ingredient – of HQ, kojic , lactic and azelaic acids, and phenylethyl resorcinol. Our recommendation is to use this product for up to three months. If one of the following occurs, these guidelines should be followed:
- If your pigmentation is relieved, then switch over to another PCA SKIN product that contains other pigment-inhibiting ingredients for maintenance. Should the pigment return, the three month cycle may be started again.
- If your pigmentation is not relieved, then stop using the HQ and switch over to another PCA SKIN product that contains other pigment-inhibiting ingredients; if the pigmentation is still present, the condition may be beyond the scope of OTC percentages and ingredients, and a physician may need to be consulted.
Before we end this blog, it is also important to know that HQ has not been banned in other countries; it is, however, regulated. This means that in some countries all percentages of HQ require a prescription – even 2% – which is still available OTC in the United States. In the United States, any percentage of HQ that is higher than 2% does require a prescription.
Many people may want to know how HQ functions within the skin when used topically. HQ has been proven to induce what is called “melanocyte-specific cytotoxicity.” This means that it is able to “seek out” melanocytes (cells responsible for producing pigment) that are not functioning properly and eliminate them, while leaving the functioning melanocytes alone. This does not mean it is cytotoxic (toxic to cells) to all of the cells in our bodies; it is only cytotoxic to the melanocytes that are not functioning properly.
Another interesting fact is that our bodies convert coffee and tea into HQ within our bodies!
We hope this helps you and your patients to have a better understanding of this ingredient. We are available at 877.PCA.SKIN [722.7546] from 7:00 am – 6:00 pm Monday through Friday, Arizona time, should you have any questions about this or any other concerns surrounding our products.