Ochronosis is a known side effect from the use of skin lightening creams, such as Hydroquinone.
Ochronosis may be permanent, as there is no known effective, long term curative treatment for this condition. The condition is most frequently reported in moderately or dark-skinned middle-aged women. Increasing hydroquinone concentration (greater than 4%) and prolonged use (greater than 1 year) increase the risk of developing Ochronosis.
In a recent systematic review (Ishack), approximately 15% of cases occurred at hydroquinone concentrations under 4%. The risks are increased further with concurrent sun exposure.
Hydroquinone is a topical medication used in a variety of hyperpigmentation disorders. It was a popular over-the-counter medication until September 2020, when the FDA reclassified it, banning its OTC distribution.
Due to documented side effects, hydroquinone is no longer legally available by prescription or over the counter in the European Union, although it is still relatively easy to procure in some parts of Europe. It is very commonly used in most developing countries and Africa.
At MLA we have safe alternatives to Hydroquinone. If you have pigment concerns, call for a consult.
Ishack, S et.al., Exogenous ochronosis associated with hydroquinone: a systematic review, International Journal of Dermatology, Vol 61 (6), 2021.
Sherman, SV (ed), Exogenous Ochronosis from Skin-Lightening Cream, New England Journal of Medicine, January 2024.
