Classifications of topical skin lightening agents

Chemical compounds (contains phenol)

I. Hydroquinone
Hydroquinone hinders the tyrosinase enzyme that turns dopa to melanin. It could interfere with the creation and eradication of melanosomes. The treatment effects of Hydroquinone are limited to the area of application and are reversible. Just 2% concentration of it is already effective. Higher concentrations are a lot more effective but doing so can irritate the skin. Persistent hypopigmentation is usually associated where levels greater than 5% have been used. The most noticeable side effect of Hydroquinone is Exogenous ochronosis, giving the skin and blackish blue discoloration. It is not advised for women who are pregnant. It is unknown that hydroquinone can penetrate the placenta so skin doctors discourage using it while pregnant or lactating.

The lightening effect of hydroquinone is observed only after several weeks to months of application. In addition to concentration, effectiveness of hydroquinone as a lightening cream also depends on other parameters such as its chemical stability in the formulation and the vehicle used. Studies have suggested the use of hydroalcoholic base as an appropriate vehicle for hydroquinone, e.g. propylene glycol and absolute ethanol in equal amounts. Stability of hydroquinone can be enhanced by antioxidants such as ascorbic acid or sodium bisulphite.

Hydroquinone is used to lighten the dark patches of skin (also called hyperpigmentation, melasma, "liver spots," "age spots," freckles) caused by pregnancy, birth control pills, hormone medicine, or injury to the skin. This drug works by blocking the process in the skin that leads to discoloration.

The effects of hydroquinone are:
Burning, itching, redness and dryness may occur. If any of these side effects persist or worsen, tell your doctor or pharmacist immediately. If your doctor has prescribed this medication, remember that he or she has decided that the benefit to you is greater than the risk of side effects.

Stop using hydroquinone and tell your doctor immediately if any of these unlikely but serious side effects occur: blistering, skin cracking, blue-black darkening of the skin. Need take skin treatment

These are a very serious allergic reaction to this drug. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching / swelling (especially of the face / tongue / throat), severe dizziness and trouble breathing.

II. Monobenzyl ether of hydroquinone (MBEH)
Monobenzyl ether of hydroquinone (MBEH) or monobenzene is melanocidal. It is selectively taken up by melanocytes and metabolized into free radicals that can destroy melanocytes permanently. Unlike hydroquinone, this mechanism is the reason for MBEH being an agent that causes irreparable depigmentation, even upon cessation of use. As a result, MBEH is usually reserved for generalized depigmentation in patients with extensive vitiligo. This process requires 9 to 12 months of continuous daily application to achieve complete depigmentation.

III. Arbutin
Arbutin is a hydroquinone glucoside that can be extracted from the bearberry plant (Arctostaphylos uva-ursi). The active component, hydroquinone, is released by the hydrolysis of the glucoside fraction. As it is released slowly, the use of arbutin may be less irritating than using hydroquinone directly.

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