Nail staining due to hydroquinone skin-lightening creams

Mann, R.J.; Harman, R.R.M.

doi:10.1111/j.1365-2133.1983.tb03976.x

Cited by 23 publications

(15 citation statements)

References 3 publications

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“…381,[386][387][388][389][390][391][392] Paradoxical pigmentation of the nails has also been reported as a side effect of the chronic use of HQ. 393,394 In contrast, ochronosis or hyperpigmentation has not been reported during the manufacture or the use of HQ in occupational settings. Occasional reports of leukoderma and/or contact dermatoses are also encountered, primarily associated with use of photographic developers.…”

Section: Dermal Effectsmentioning

confidence: 94%

The Toxicology of Hydroquinone — Relevance to Occupational and Environmental Exposure

DeCaprio¹

1999

Critical Reviews in Toxicology

174

128

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Hydroquinone (HQ) is a high-volume commodity chemical used as a reducing agent, antioxidant, polymerization inhibitor, and chemical intermediate. It is also used in over-the-counter (OTC) drugs as an ingredient in skin lighteners and is a natural ingredient in many plant-derived products, including vegetables, fruits, grains, coffee, tea, beer, and wine. While there are few reports of adverse health effects associated with the production and use of HQ, a great deal of research has been conducted with HQ because it is a metabolite of benzene. Physicochemical differences between HQ and benzene play a significant role in altering the pharmacokinetics of directly administered when compared with benzene-derived HQ. HQ is only weakly positive in in vivo chromosomal assays when expected human exposure routes are used. Chromosomal effects are increased significantly when parenteral or in vitro assays are used. In cancer bioassays, HQ has reproducibly produced renal adenomas in male F344 rats. The mechanism of tumorigenesis is unclear but probably involves a species-, strain-, and sex-specific interaction between renal tubule toxicity and an interaction with the chronic progressive nephropathy that is characteristic of aged male rats. Mouse liver tumors (adenomas) and mononuclear cell leukemia (female F344 rat) have also been reported following HQ exposure, but their significance is uncertain. Various tumor initiation/promotion assays with HQ have shown generally negative results. Epidemiological studies with HQ have demonstrated lower death rates and reduced cancer rates in production workers when compared with both general and employed referent populations. Parenteral administration of HQ is associated with changes in several hematopoietic and immunologic endpoints. This toxicity is more severe when combined with parenteral administration of phenol. It is likely that oxidation of HQ within the bone marrow compartment to the semiquinone or p-benzoquinone (BQ), followed by covalent macromolecular binding, is critical to these effects. Bone marrow and hematologic effects are generally not characteristic of HQ exposures in animal studies employing routes of exposure other than parenteral. Myelotoxicity is also not associated with human exposure to HQ. These differences are likely due to significant route-dependent toxicokinetic factors. Fetotoxicity (growth retardation) accompanies repeated administration of HQ at maternally toxic dose levels in animal studies. HQ exposure has not been associated with other reproductive and developmental effects using current USEPA test guidelines. The skin pigment lightening properties of HQ appear to be due to inhibition of melanocyte tyrosinase. Adverse effects associated with OTC use of HQ in FDA-regulated products have been limited to a small number of cases of exogenous ochronosis, although higher incidences of this syndrome have been reported with inappropriate use of unregulated OTC products containing higher HQ concentrations. The most serious human health effect related to HQ is p...

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Section: Dermal Effectsmentioning

confidence: 94%

The Toxicology of Hydroquinone — Relevance to Occupational and Environmental Exposure

DeCaprio¹

1999

Critical Reviews in Toxicology

174

128

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“…Only a few cases of nail staining by hydroquinone have been reported previously. All patients were Caucasian using 2-5% hydroquinone topically [2][3][4][5][6].The acquired hyperpigmentation generally presented in the distal part of the fingernails of one or both hands, was asymptomatic, and worsened with sun exposure although this was not seen in this case. Cessation of the hydroquinonecontaining creams or use of gloves to protect the nails resulted in complete resolution of the discoloration within 1-3 months [2][3][4][5][6].…”

Section: Discussionmentioning

confidence: 70%

“…Hydroxyquinone is another yellow compound and further light exposure causes it to polymerize to products which are dark brown in color [2,3]. The resolution of the nail staining during the winter months in a patient reported by Mann et al strongly suggests that UV light may be an important etiologic cofactor [3]. The yellow-brown pigment histologically resembles the dermal deposits seen in exogenous ochronosis.…”

Section: Discussionmentioning

confidence: 86%

“…Hydroquinone undergoes oxidation to quinone, a yellow compound that is subsequently oxidized to hydroxyquinone in the presence of light. Hydroxyquinone is another yellow compound and further light exposure causes it to polymerize to products which are dark brown in color [2,3]. The resolution of the nail staining during the winter months in a patient reported by Mann et al strongly suggests that UV light may be an important etiologic cofactor [3].…”

Section: Discussionmentioning

confidence: 96%

“…This tyrosinase-inhibiting phenolic compound has a few well-known adverse effect such as allergic contact dermatitis and exogenous ochronosis after long-term use. However, pigmentation of the nails as a complication of topical hydroquinone is relatively uncommon, with only a few reports in the literature [2][3][4][5][6]. We present a case of nail hyperpigmentation after use of a 4% hydroquinone-containing cream for treatment of facial dyschromia.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Reversible Nail Discoloration from Hydroquinone 4% Cream

2018

J Clin Investig Dermatol

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Phenol and Phenolics

Cavender,

O'Donoghue

2023

Patty's Toxicology

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The phenolics used for industrial and commercial purposes are a large and diverse group of chemicals as the six‐member ring of phenolics can be methylated, halogenated or include other moieties that add properties or toxicological potential that is not observed with simple phenolics. For simple dihydroxy phenolics, the largest exposure potential can be through their presence naturally in foods. Low concentrations of chlorophenols are commonly found in drinking water due to water chlorination processes. Simple methyl phenols are commonly used as disinfectants. More complex phenolics such as creosote and pentachlorophenol are used as wood preservatives. The acute toxicity of phenolics at relatively high doses is manifested as excitation of the nervous system causing muscle tremors, salivation, and in severe cases, convulsions. The excitatory phase of phenolic intoxication gives way to depression of the nervous system and can result in mortality. Acute and repetitive exposure to phenolics can result in liver and kidney toxicity. A number of phenolics can be absorbed through skin and are readily absorbed after ingestion. Major metabolites of phenols are sulfates and glucuronide conjugates that are excreted through the kidneys. First pass metabolism present on ingestion is not a factor for phenols absorbed through the skin. Therefore, the toxicity of phenolics may differ depending on route of exposure.

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Nail staining due to hydroquinone skin-lightening creams

Cited by 23 publications

References 3 publications

The Toxicology of Hydroquinone — Relevance to Occupational and Environmental Exposure

The Toxicology of Hydroquinone — Relevance to Occupational and Environmental Exposure

Reversible Nail Discoloration from Hydroquinone 4% Cream

Phenol and Phenolics

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