Therapists should be alarmed to read about recent research relating to hydroquinone causing cancer. Although hydroquinone creams are banned for use in cosmetics you may be still be giving hydroquinone to your clients without being aware. Recent evidence on the long term damage of hydroquinone has made this a critical issue for therapists to assess management of client's pigmentation issues.

Hydroquinone has been used for many years to reduce pigmentation by acting on melanin producing cells. This action can destroy the pigment making cells (melanocytes) and alter the structure of melanosomes (packets of pigment which are made by the melanocytes and passed to new skin cells as they are formed).

Hydroquinone was banned in January 2001 in cosmetics because of the potential damage it can do to the skin in terms of irritating the skin and creating white areas where no pigment can be made or in some cases turning the skin black. It is still prescribed by dermatologists in hospital but they are gradually switching to alternatives as new safety data comes to light. Recent studies have shown the potential of hydroquinone to cause cancer.

Significant importation of hydroquinone creams still occurs from countries where it is yet to be banned and a strong black market trade exists in the UK. This is bad enough but more concerning is that companies can still sell products containing arbutin and bearberry legally. Arbutin is the glycopyranoside of hydroquinone. This mouthful means that when this molecule is in the skin it breaks down and releases hydroquinone. Bearberry is a natural source of arbutin. So in fact many people are still effectively getting hydroquinone albeit by a different method. This issue of substitute sources of hydroquinone has been raised with the EEC but they have yet to respond; although they have classified hydroquinone as a potential cancer agent.

Hydroquinone has been shown to cause blood cancers such as leukaemia and kidney damage in animal studies. When applied to the skin it is absorbed into the blood stream and excreted via the kidneys but at a slower rate. This tells us that hydroquinone accumulates in the body. It is broken down in the bone marrow to p-benzoquinone and this is where long term damage may originate.

Hydroquinone creams are routinely used for four to six weeks minimum and many people use it for social lightening of a dark complexion over many years. There is strong evidence now that safer alternatives should be used which are as effective in many cases but without the long term risks.

This information has been brought to light by a recent review by Dr W Westerhof and T J Kooyers of the Netherlands Institute for Pigment Disorders and the Department of

Dermatology at the University on the health risks of hydroquinone and its analogues. They are pleading with the authorities to ban all sources of hydroquinone immediately.

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