Side effects of hydroquinone 4% – is ochronosis really a concern?

I am using hydroquinone 4% prescribed by a dermatologist. After reading about ochronosis on the internet, I'm quite scared. What are the symtoms of this? Does it appear immediately or is it gradual?

In the United States, the drugstore ‘lightening’ products are generally 1-2% hydroquinone.  Over that percentage, hydroquinone is available only by prescription through a doctor.   In the United States, it’s extremely rare to see ochronosis unless the person came from another continent, particularly certain countries in Africa and Asia.  It’s due to prolonged use or high concentrations or both. Here is some more information on pigment problems.

In some countries, hydroquinone is not regulated at all and is often used in high concentrations over a long period of time.  That fact, combined with the social premium on lighter skin in some cultures, leads to abuse and over use.  

It’s wise to be careful with these products.  Our offices uses them for limited periods of time, in only certain patients, in the lowest prescription concentration which is 4%.  The European Union banned it a few years ago, due to possible cancer in mice at high concentrations.   Dr. I

Dr. Brandith Irwin, MD

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