- If you have dark marks from acne, scars or melasma, you have normal skin.
- If you have skin that has gotten darker through years of tanning or being under the sun, you have normal skin.
Compare that to the skin of a vitiligo sufferer, whose immune system is attacking melanocytes. And before I go on any further, I think it’s important for you to first understand what vitiligo is.
So what is vitiligo?
Vitiligo is a relatively common skin disease affecting about one out of every hundred people. With vitiligo, the body works to kill melanocytes (cells that give us our colour) causing the skin to turn white in patches. This bleaching effect can also sometimes affect hair as well as mucous membranes inside the nose and mouth.
No one knows what causes vitiligo for sure. For now, only theories exist. Vitiligo may be due to:
- Genetic causes
- Environmental Causes
- Autoimmune abnormality
The disease can spread, rapidly or slowly, to cover the entire body surface (universal vitiligo) but the most common form appears in a symmetrical form (generalized vitiligo). Sometimes, only half of the body is affected (segmental vitiligo).
Vitiligo affects both men and women regardless of skin colour or ethnicity. Vitiligo can occur at any age, but most develop it before they turn twenty. It is not infectious. Meaning you cannot catch it from someone with vitiligo.
More information on vitiligo and vitiligo support:
And what is monobenzone?
Monobenzone is a depigmenting treatment for cases of extensive vitiligo, where the patches of white skin are too large to be treated for repigmentation.
There are a few things you should know about this chemical called monobenzone:
- Scientists still do not fully understand how monobenzone works.
- Its effects are unpredictable and may not lead to complete depigmentation.
- Monobenzone is usually also the last resort for someone with vitiligo.
Monobenzone creams appear to cause depigmentation by killing the skin’s melanocytes. However, later studies have shown that while it probably kills melanocytes in the epidermis, it has no effect on the follicular reservoir. Therefore, it is not unusual for spots of original colour to return after a few years of good results. Sun exposure may possibly speed up the return of pigmentation.
In vitiligo sufferers, monobenzone use may lead to pigment-free skin within 1 to 2 years. However, monobenzone has unpredictable effects, and even vitiligo sufferers being treated with monobenzone by their doctors have difficulty maintaining their even and white colour. Spots of pigmentation may reappear after several years because of the follicular reservoirs that can produce melanin.
Michael Jackson (may he rest in peace), was the world’s most famous person with vitiligo. Yet, even after what was probably years of intense monobenzone treatment with the best doctors and all the resources he had, Michael Jackson still had to live under a veil of makeup and gloves. It is important to realize that even for vitiligo sufferers being treated with monobenzone by their doctors, make-up and other ways of camouflaging the skin often become a way of life, as patches of colour may remain resistant to depigmentation.
Yet another downside… monobenzone poses risk to others
The process of completely depigmenting the skin with monobenzone is a long one (1-2 years). Unlike other skin treatments, using monobenzone could also put family members and close ones at risk of depigmenting due to accidental skin contact. Because monobenzone has to be handled carefully, vitiligo patients have to take extra precautions so that the cream does not inadvertently transfer itself through skin contact with members of their household. Thus, vitiligo patients undergoing monobenzone depigmenting treatment often only apply the cream when their children are at school to minimize the risk.
- Q: Is monobenzone like hydroquinone?
- A: No!
Most people desperate to lighten their skin make the mistake of thinking that monobenzone is one step up from hydroquinone and that it can boost their skin lightening progress. This is simply wrong.
Monobenzone should not be compared to hydroquinone or any other skin lightening ingredient. This is because monobenzone is not a skin lightener. In fact, it is unlike any other skin lighteners out there. Because of what it can do, monobenzone is in a class of its own. I am not sure where the confusion between monobenzone and hydroquinone started, but perhaps it is because monobenzone is also referred to as ‘monobenzyl ether of hydroquinone’.
Yes, it is true that monobenzone and hydroquinone are both ‘phenols’ and have similar chemical structures (see the table below), but the effects they have on the skin are as different as night and day.
If you do not have the time to read this entire page, the table below will give a quick summary of the differences between the effects of monobenzone and hydroquinone on normal skin of people who do not have vitiligo. If you do have time, read on — it just might save your skin!
Effects of monobenzone and hydroquinone on non-vitiligo users:
First few months: Initial white patches all over the body, including areas not treated with monobenzone.
One year: Large portion of the body has turned white.
If usage stops: When you stop using monobenzone, melanocytes will become active. Old skin color will start to reappear causing distress and very patchy, uneven skin.
If usage continues beyond one year: Raw areas of pink skin may emerge, mixed with white patches. Spots of original coloring may emerge within a few years due to follicular melanocytes. Monobenzone becomes ineffective on these spots as the returned pigment has become resistant to the chemical. The overall effect can be devastating mentally, emotionally and psychologically.
First few months: Skin color lightens a few shades where it is applied.
One year: Hydroquinone use should be limited to fewer than six months. Using it for longer can cause the opposite desired effect, skin darkening, and damage.
If usage stops: If the skin is healthy, the lighter shade can be maintained through regular sunscreen use. Otherwise, any lightening achieved can be easily reversed.
If usage continues beyond one year: The skin has a high risk of developing abnormal pigmentation like exogenous ochronosis.
What monobenzone does to normal skin
- Initially, white patches, white spots and streaks all over the body (regardless of where the cream is applied)
Unlike skin lightening creams which only lighten the areas it is applied to, monobenzone applied anywhere on the body will lead to white patches in different areas. For example, if you applied monobenzone on your face, you could develop permanent white patches and streaks on your arms, legs and torso as well.
- After one year… white skin, with ruddy or pinkish tones
Because monobenzone creams kill the skin’s melanocytes, you can expect completely white and pinkish skin following depigmentation. This usually occurs after approximately one year of monobenzone use. The skin colour will be similar to a person with albinism. Physical activity and exercise will lead to ruddy-looking skin and flushing as the blood beneath the skin’s surface will show up clearly without any pigment to tint its appearance.
- Within one to two years, the skin may start to repigment itself
While this repigmentation may happen to vitiligo sufferers as well, it occurs sooner and more aggressively in people with normal skin. This is because vitiligo sufferers’ immune systems are constantly attacking their own pigment cells. There is no such action in people with normal skin. In fully-functioning immune systems, melanocytes will become active again. Spots and patches of pigmentation will start to appear over the previously white skin, leading to a patchy appearance.
Unlike the initial stage of using monobenzone, applying monobenzone to bleach these repigmented spots will likely have no effect. This is because the newly re-emerged melanocytes would have become resistant to monobenzone, so that even higher concentrations like 40% monobenzone may have little or no effect. In other words, at this late stage, monobenzone will stop working on the skin.
- If the skin does not repigment, expect a lifetime of zero sun protection
Because melanin offers sun protection, completely depigmented skin that has no melanin offers zero sun protection. Vitiligo sufferers who have successfully depigmented need to wear hats, long sleeves and long pants outdoors all the time to protect themselves from sun damage. Even on cloudy days, sunscreens with broad coverage are a must.
The consequences of monobenzone use on people with normal skin
Often, someone without vitiligo who uses monobenzone in sufficiently high percentages (e.g. 20% monobenzone) and over a long period of time will have to be treated by a doctor as a new ‘vitiligo’ patient as there exists no way yet to reverse the damage caused by monobenzone.
Additional Information on Monobenzone:
Monobenzone goes by several other chemical names.
- Benzyl hydroquinone
- Hydroquinone benzyl ether/Hydroquinone monobenzyl ether
- Monobenzyl ether of hydroquinone/Monobenzyl hydroquinone
- Benzyl p-hydroxyphenyl ether
- p-Hydroxyphenyl benzyl ether
Monobenzone is distributed and sold under these brand names (this is not an inclusive list).