Causes of Exogenous Ochronosis
Exogenous ochronosis can be caused from long term usage of certain ‘’skin lightening products’’, even if the hydroquinone is in amounts as small as 2%. Skin lightening products are still prevalent in many parts of the world. Reasons for this may be due to aesthetic or social standing reasons, in areas where a lighter skin tone is considered to be a sign of wealth or beauty. As well, skin-lightening creams containing compounds such as hydroquinone are commonly used to help with hyperpigmentation disorders such as melasma.
Hydroquinone is the compound most frequently used in skin whitening products. Due to concerns about its side effects, it was almost banned by the FDA in 2006, as there were medical issues of carcinogenicity and reports of disfiguring ochronosis. In the European Union Hydroquinone has been banned in cosmetic creams since 2000.
Long term use of creams containing this compound may lead to exogenous ochronotic lesions. The duration of the use is directly proportional to the risk of developing the condition with most cases being after years of use. Around 10-15 million skin lightening products are sold annually, with Japan being the major buyer.
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