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Skin Care and Diseases

Skin Lightening Cream

05/16/2005

Question:

Does the prescription skin lightening cream, Hydroquinone 4%, remove or lighten a red mark on the skin versus just working on brownish colored discolorations? Or would the Cetyl & Stearyl alcohol and Glycoloic Acid that it contains tend to make it even redder? Thank you.

Answer:

The hydroquinone 4% cream that you are using inhibits pigment granule formation within the pigment-forming cells.  It will cause lightening of the skin, some of which may be reversible.  It rarely destroys the melanocytes so it has a fine safety margin.  If you are trying to lighten your skin you should always wear a sunscreen on the exposed areas to get to your desired result and to prevent repigmentation. 

The vehicles of most skin preparations have various long-chain alcohols as part of their formulation.  It is important to promote movement of the medication from the vehicle to and into the skin.  Many of them are mildly irritating, but for the most part they tend to not to produce irritation.  If you have small cherry angiomas (red spots) the hydroquinone will have no impact upon them and you correctly observed that it might be low-grade irritation.  I would not use the hydroquinone on the vascular lesions.

If you have any concerns, I would consult your board certified dermatologist so that you may have a very accurate evaluation of the pigmented lesions that you are trying to lighten.

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati