Hydroquinone, found in skin-lightening agents worldwide, linked with increased skin cancer risk
The people who use skin-lightening products may be at an increased risk for skin cancers, according to an analysis of records from a research database.
Hydroquinone is linked to an increased risk of skin cancer by three times. The study found that this risk should be disclosed to patients considering treatment. It was surprising how significant the risk is.
The results were presented in a poster at the annual meeting of a society for investigative dermatology.
Hydroquinone is an FDA-approved skin lightener that was very safe, but in recent experiments, it causes cancer and other severe side effects.
Hydroquinone use in over-the-counter products is restricted to the United States due to concerns of carcinogenicity. The FDA issued warning letters to 12 companies selling hydroquinone with concentrations not recognized as safe and effective.
Researchers analyzed data from patients in the United States using TriNetX, a database containing information compiled from patients with medical records that provide insights into diagnoses and treatments.
Patients with no prior diagnosis of skin cancer were studied. Treated with hydroquinone and the other group had not. The researchers used ICD-10 codes to find which type of skin cancer these individuals were likely to develop.
The biggest weakness of the study is that it cannot be determined how long and how consistently the patients used hydroquinone, according to Ms. Miles.
Skin lightening is a big business, and more research is needed.
Ms. Miles says the U.S. market for skin-lightening agents will be around 330 million dollars in 2021 and required 330,000 prescriptions in 2019 that contain hydroquinone.
Valencia D. Thomas, MD, said that people of color commonly use over-the-counter skin-lightening products containing low-concentration hydroquinone.
The FDA issued a warning letter in April. Unfortunately, products are available that are more concentrated than what is studied. And also not subject to regulations.
Tri-Luma at 4% concentration is the only FDA-approved Hydroquinone medication that treats melasma.
Dr. Thomas said that the data in the study do not show an increased risk for cancer with hydroquinone exposure. It showed a higher risk for those exposed to TriNetX-5509 which does not prove causation.
The lack of specificity in the phrase "hydroquinone exposure" is a cause for concern. It's unclear how TriNetX identified the hydroquinone exposure cohort and whether "exposure" is by counting unused prescriptions, high-concentration products not approved by the FDA, or over-the-counter products.