Skin lightening preparations and the hydroquinone controversy.
Skin lightening preparations are widely used in dermatology by persons of all Fitzpatrick skin types. Fitzpatrick skin types I-III require local pigment lightening for the treatment of hormonally induced melasma and postinflammatory hyperpigmentation caused by acne and trauma. Fitzpatrick skin types IV and darker have an even greater need for skin lightening for social reasons, as well as pigmentary changes that occur around the eyes, in the intertriginous areas, following dermatitis, or with acne and trauma. The gold standard dermatologic agent for skin lightening was hydroquinone, until regulatory agencies in Japan, Europe, and most recently in the United States questioned the safety of this substance. This has encouraged research into alternative agents to inhibit skin pigmentation such as retinoids, mequinol, azelaic acid, arbutin, kojic acid, aleosin, licorice extract, ascorbic acid, soy proteins, and N-acetyl glucosamine. The efficacy and safety of each of these ingredients is examined as possible topical alternatives to hydroquinone.
Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. zdraelos@northstate.net
Zoe Diana
ZD
Draelos
D000287:Administration, Topical; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004954:Esthetics; D005260:Female; D006801:Humans; D006873:Hydroquinones / Q000009:adverse effects / Q000627:therapeutic use*; D017495:Hyperpigmentation / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008548:Melanosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D017060:Patient Satisfaction; D012176:Retinoids / Q000009:adverse effects / Q000627:therapeutic use; D018570:Risk Assessment; D012720:Severity of Illness Index; D017592:Skin Care / Q000379:methods; D016896:Treatment Outcome
D003879:Dermatologic Agents; D006873:Hydroquinones; D012176:Retinoids; C031927:hydroquinone