Countries and Regions where Hydroquinone and Other Skin Lightening Ingredients are Banned
We have compiled a list of countries and regions, info on the circumstances which led to the ban plus the current status of these bans.
The demand for skin lightening products continues to grow with the industry projected to hit US$31.2 by 2024. This is according to a report published by Global Industry Analytics.
The monumental growth is being driven by penetration of skin lightening products use by men, glamour for non surgical skin lightening procedures, inclusion of skin lighteners in anti-aging products and also the venture into natural skin lightening products which are considered safer among other things.
So, where does hydroquinone feature in all this? Skin lightening and hydroquinone are inseparable; hydroquinone is actually considered the ‘gold standard’ for skin depigmentation agents.
For more than 50 years, hydroquinone has been used effectively for skin lightening. To date, it is still among the most commonly used skin lightening ingredients. Despite this, there are several countries and regions where hydroquinone is banned.
The Food and drug Administration (FDA), proposed a rule to declare OTC skin bleaching products as no longer ‘GRASE’ (Generally Recognized As Safe and Effective) on 29th August 2006. This would revoke a September 1982 proposal that had considered OTC skin lightening products containing 1.5-2.0% hydroquinone as GRASE.
The FDA attributed the proposed rule to lack of enough data to determine the safety of or make a restrictive position concerning hydroquinone use. The conclusion was based on;
- Contradictory results on the effect of hydroquinone on fertility
- The high absorption rate of the compound into the skin
- ‘Some evidence’ of hydroquinone carcinogenicity
- Researches on cases of exogenous ochronosis, a condition characterized by bluish-black pigment associated with use of hydroquinone containing skin lightening products.
The proposed ruling triggered a response from some stakeholders in the industry, the American Health & Beauty Aids Institute (AHBAI) and the Dermatology Section of the National Medical Association (NMA). In their quest for review, they requested FDA to;
- Analyze available pharmacology/toxicology data on hydroquinone since 1982
- Consider testing the use, effects and risks of hydroquinone products use on well defined populations
- Review ochronosis cases in US only and ignore African cases which authors of various reports associated with hydroquinone concentrations of up to 6-8.5%. The stakeholders added that the US cases were rare and were also responding to medication contrary to the African ones.
The American Academy of Dermatology Association (AADA) also wrote to FDA citing that FDA underestimated the benefits that OTC hydroquinone offered to patients of dyschromia who would probably have no access to further medical care. They also pointed out how rare ochronosis was in US and the lack of evidence to connect hydroquinone to cancer in humans.
Faced with such reactions, FDA recommended further research and testing to conclusively determine both the topical and system effects of hydroquinone use. Pending such investigations, concentration of up to 2% of Hydroquinone is available over the counter in US, while concentrations of 4% and above requires prescription.
In Europe, the use of Hydroquinone has been banned for use in skin lightening products since January 2001. Its use in skin lightening has been associated with leukoderma-en-confetti, a condition that is characterized by confetti like depigmented areas of the skin, and ochronosis.
Prior to the ban, Hydroquinone was the most common ingredient in skin lighteners. However, its use was limited to localised areas of the skin such as age spots under the European Cosmetic Regulation. Eventually, it became evident that it was being used on larger areas and that its use was linked to the above conditions plus other possible health risks.
As it turns out, numerous articles about the carcinogenicity of hydroquinone and possible long-term effects have been published since 1996. It was these findings that led to the ban in 2000.
The ban took effect beginning January 2001. Regardless of the burn, the skin lightening industry is thriving and skin lightening products containing hydroquinone and mercury, both of which are banned for use in EU are still finding their way to the shelves.
On the other hand, Hydroquinone is allowed for use in other cosmetic products such as artificial nails and hair colorants. Other products that have been banned in EU for use in skin lightening are steroids.
Africa is well known for its wide usage of skin lightening products. Some countries have however put measures in place to shield their populations from dangers that are associated with some ingredients in skin lightening products. These measures include either banning or putting restrictions on the ingredients.
In Kenya, the Kenya Bureau of Standards (KEBS) banned the use of cosmetic products containing ingredients considered harmful. Among the list of ingredients is hydroquinone, mercury and hydrogen peroxide. The products were banned due to their association with harmful effects on the skin and body in general. The ban was gazetted on 14th August 1998.
In Tanzania there is widespread use of skin care products which contain mercury and hydroquinone. These products are however banned for import but they still find their way into the country through smuggling. Research carried out by the Danish Ministry of Foreign Affairs found out that most of the antiseptic soaps sold in the country contained mercury.
Although these soaps are marketed as antiseptics, the main reason behind the huge sales is their ability to make the skin paler. The countries of origin for these soaps which also contain hydroquinone were identified as mostly UK and Italy.
The banning of these ingredients in the two East African countries follows a similar script across the African continent: Ghana and Nigeria have also banned the use of such products. It is rather ironic that use of skin lighteners containing mercury, hydroquinone and corticosteroids has been banned in Nigeria given that it takes the lion’s share of skin lightening cases in Africa.
Statistics show that 75% of Nigerian women use skin lighteners.
Most countries have actually gone a little further and banned all cosmetics containing any lightening ingredients. One such country is Ivory Coast which passed laws to that effect in 2015.
Rwanda also joins the list of African countries which have put measures in place to curb the use of toxic skin lighteners. The fight has however taken a much intenser approach in this tiny Central and East African country. It all started with a tweet from the president calling on authorities to ‘reign on’ prohibited chemicals.However, what caught the attention of many was the inclusion of police in the directive. A role which was reserved for the country’s standards bureau since 2013, when a ban on 1342 brands was enacted, became policed overnight. What followed was a countrywide multi-agency effort leading to the seizure of over 5,000 banned skin bleachers, all in under a weeks’ time.
To better understand whether banning of these toxic ingredients has been effective, let’s look at a research carried out in South Africa back in 2015. The country is among those that have banned toxic-level hydroquinone and mercury use in skin lighteners.
An examination of 29 products in the capital, Cape Town found that 22 of them came from illegal vendors and 2 were sold freely OTC. What was more telling is that the illegal batch contained high levels of mercury, hydroquinone and steroids.
To make matters worse, the ingredient lists did not contain the toxic substances.
There are calls in most parts of Africa to ban the use of hydroquinone and other skin lightening ingredients which are considered harmful. Some good examples are Senegal and the Democratic Republic of Congo. Whether that has happened is a different story altogether; we have not found any quantifiable data to verify if actual steps have been taken.
For a continent so renown for its use of herbal remedies to treat practically any condition, maybe it is time that people were made aware of natural and safer skin lightening methods.
United Arab Emirates
In the UAE, cosmetic products that contain hydroquinone can only be sold with a prescription. This directive has however not been so effective with OTC creams having been found to contain hydroquinone. Manufacturers were found to circumvent the law by not disclosing the full list of ingredients on the products’ label; the most toxic ones like hydroquinone and mercury get left out.
In UAE, the Ministry of Health and Prevention has warned the public against the use of these creams. Skin lightening creams, especially those sold over social media, have been of major concern. This has greatly been attributed to the rise of online influencer marketing; whereby teenagers are looking up to online personalities to guide their purchasing habits.
Health officials have actually issued a warning against the use of some specific creams. Such have been have found to have beyond prescription-level concentrations of hydroquinone and mercury. These warnings have been issued in all UAE states including Abu Dhabi, which unregistered three skin lightening creams early this year for being toxic.
The global demand for hydroquinone continues to grow with the Asia-Pacific market accounting for the lion share. A survey by Synovate found that at least every 4 in 10 women in Asian countries use skin lighteners. In the region, China and India take the lead in skin lightening consumption due to large populations and the ever growing glamour for lighter skin.
Cambodia has banned the use of specific skin whitening creams that were believed to come from Vietnam. This was in 2010, after a 23-year old woman was suspected to have died due to use of toxic skin lightening cream. An earlier research had found 9 out of 41 brands to have contained high levels of mercury (2000 ppm, parts per million) which is way beyond allowable limit of 1 ppm. One whitener was actually found to have contained 12,590 ppm.
Another country in the region which has banned use of these ingredients is Thailand.
The sultanate of Brunei, a southeast-Asian country has also banned use of toxic ingredients in cosmetics products. The ban has seen many cosmetic products being recalled from the shelves. These include products with hydroquinone, mercury and minoxidil, a hair loss treatment.
In 2011, Philippines banned products with mercury levels that exceed the regulatory limit of 1 ppm. Same goes for Japan who’s Standards for Cosmetics banned the use of hydroquinone and mercury in April 1, 2001.
When it comes to skin lightening, hydroquinone sparks lots of controversy. Countries all over the globe have actively debated on its use in cosmetic products. The measures taken concerning its use in skin lightening include regulating its use or outright banning. When it is mentioned in bad light, it is usually in the company of other ingredients like mercury and steroids which are known to be harmful to human health.
The above countries and regions are just but a representation of what is happening out there. There might not exist enough evidence to support the short and long term effects of hydroquinone but when so many parts of the world make noise, it is hard to ignore.
Sonia Knight is the founder of be:skinformed.
Apart from having her own experience with hyperpigmentation, Sonia has gained vast knowledge in the dermatology field. For more info on this, check out our about us page.