Monobenzone for Non-Vitiligo Patients with Hypopigmentation?

Question

I have systematic hypopigmentation as the result of experimental fractional CO2 laser and TCA procedures. I have applied 20 grams of 20% monobenzone once daily. After 1 month, I have developed hypopigmented burns that crinkle when pressed inward. Is 20% monobenzone safe for non-vitiligo patients, or do you have experience applying monobenzone for non-vitiligo patients? There are no clinical studies on monobenzone for non-vitiligo patients. Is 20 grams too much?

Anna Chacon, MD, FAAD · Answer

Monobenzone is a depigmenting agent primarily used for patients with vitiligo to achieve uniform skin tone by depigmenting the remaining pigmented areas. Its use in non-vitiligo patients, particularly for conditions like hypopigmentation resulting from laser or chemical treatments, is not well-documented or recommended due to potential adverse effects. Here are some considerations:

Safety Concerns: Monobenzone is not typically recommended for individuals without vitiligo because it can cause permanent depigmentation and may lead to uneven skin tone or further hypopigmentation, as you've experienced. The "burns" and crinkling you describe are likely adverse reactions to the monobenzone.

Dosage and Application: Applying 20 grams of 20% monobenzone daily is quite a high amount, especially for off-label use. This could increase the risk of side effects. In vitiligo patients, monobenzone is usually used under strict medical supervision with careful monitoring.

Lack of Clinical Studies: As you mentioned, there are no clinical studies supporting the use of monobenzone for non-vitiligo patients, which makes its safety and efficacy in such cases uncertain.

Recommendation: It is crucial to stop using monobenzone and consult with a dermatologist or healthcare professional as soon as possible. They can assess your skin condition and recommend safer, more effective treatments for managing hypopigmentation.

Alternative Treatments: Your dermatologist may suggest options such as topical corticosteroids, calcineurin inhibitors, or other therapies that are more appropriate for managing hypopigmentation without the risk of causing additional skin damage.

Please prioritize consulting with a healthcare professional to ensure you receive appropriate care and avoid further complications.

Monobenzone for Non-Vitiligo Patients with Hypopigmentation?

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Monobenzone for Non-Vitiligo Patients with Hypopigmentation?

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