Is Hydroquinone treatment safe if one suffers from Exogenous Ochronosis?

I have really dark patches on my forehead due to 2 years of 2% HQ use on and off. Doctors have ruled out exogenous ochronosis but I didn't have biopsy so I can't say it really isn't. I have been away from HQ for 18 months and now started using prescribed 6% HQ (with Kojic acid, Retin A, and Hydrocortisone) with a really good sunscreen at all times. Even if it were Ochronosis, would this cream make my situation any worse considering I'm using HQ after 18 months? Thanks!

Doctor Answers 2

Exogenous Ochronosis -- Try VI Peel

I have found that if you have very dark pigment that is unresponsive to HQ then using more HQ doesnt really help.  you need alternative lightening creams in combination with peels, usually sal acid peels over time or the VI peel.  Laser genesis is sometimes helpful and so is venus viva (radiofrequency).  I suggest staying away from laser heating.  It may take a long time to respond.  Best, Dr. Emer.


Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Dark Skin and Hydroquinone

If you do have ochronosis I would NOT use the Hydroquinone, now or in the future.

If you have hyperpigmentation of another cause, I would be clearer about the specifics of your particular situation before starting any other treatment protocols.  Only a highly qualified Dermatologist with lot's of experience in this arena should direct your future therapy.  Mismanagement at early stages can lead to further darkening and sometimes, a situation that cannot be completely remedied.  Good luck with your skin.

Bruce Saal, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

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