Topical creams designed to lighten skin color are enormously popular. Sales of these over-the-counter products have grown tremendously over the past few years. The active ingredients don’t actually depigment the skin, rather, they work mostly on freckles, blotches and other pigmented spots to give skin a more even, lustrous appearance.
4% Hydroquinone is the bleaching chemical found in prescription creams like Lustra, Tri-Luma, and EpiQuin Micro. A licensed physician writes a prescription and it is only sold through pharmacies. A weaker 2% formula has been available over-the-counter in products like DDF Fade Gel4 and Philosophy’s Pigment of Your Imagination (clever name!)
Hydroquinone has been on the cancer watchlist for decades, both because of animal studies (rats given tons of hydroquinone to ingest) and retrospective health surveys that compared cancer risks by occupation/environmental exposure. Statistically, lifelong excess exposure to hydroquinone is associated with an increase cancer risk, so the FDA wants to ban OTC sales of hydroquinone. Many dermatologists claim limited topical use does not pose a genuine hazard. Either way, the stronger prescription version will likely remain available.
Instead of hydroquinone there are safe subsitutes to reduce the intensity of skin discolorations. Shiseido and Dior use proprietary formulas based on natural plant derivatives. Licorice extract, azelaic acid, mulberry extract and bearberry extract all tend to inhibit skin melanin pigment synthesis. An experienced aesthetic dermatologist or cosmetician can help you decide which skin lightening cream will work best for you.