Depigmentation FAQ

[What's depigmentation?]

Depigmentation is the absence or loss of pigmentation (or less than normal pigmentation) in the skin or hair not the same as Albinism, but people have various responses to total depigmentation. The eye color is not affected. The lips, mouth, and nipples usually retain their darker tone. Some have seen loss of body hair color, while retaining color in their eyebrows, eyelashes, and on their heads. In fact, it is considered a good sign if body hair is white since pigment can be retained lower in the skin, in the hair follicles, where it may be stimulated (by sun? by chemicals?) to reproduce and create freckles of normal skin tone, even years after total depigmentation. When those hairs turn white, it indicates the pigment no longer exists. In the future, if spots of pigment appear, it will require another regimen of spreading the monobenzone cream on the affected areas for weeks or months to eradicate the new pigment. Using sunblock on exposed skin helps prevent recurrence of pigment.

[Depigmentation leads to greater chance of skin cancer?]

Claims that vitiligo or depigmentation leads to greater chance of skin cancer are not true. In fact, a vitiligo expert stated that with the total loss of melanocytes (depigmentation), it would be virtually impossible to get melanoma, the most serious form of skin cancer. Rates of cancer for those with vitiligo are not higher than for those without it.

[How white is a depigmented person?]

The whiteness produced by depigmentation is not like a white sheet of paper; it is modulated by the blood vessels, hair, and exposure to sun. It is true that the blood vessels may be seen more prominently, particularly on the hands. But it’s pretty much depends of each person as we all are different and we have differents systems.

[wich are the depigmenting treatments?]

The most common method of depigmenting is the use of the prescription cream “Monobenzylether of hydroquinone” which is commonly called “monobenzone” and sold with the brand name “Benoquin.” This drug has one use: to remove remaining pigment in those with extensive vitiligo. It is not to be used for general skin lightening or the removal of freckles or other pigmentary disorders. Again: The sole indication for this drug is for final depigmentation in extensive vitiligo. While Benoquin is sold packaged in tubes with a 20% strength, monobenzone can be compounded to other strengths at a compounding pharmacy or via internet vendors. In any case, this is a prescription drug and should never be misused. Typically, the cream is rubbed into the skin daily, or twice daily, for months, sometimes years. The packaging with Benoquin indicates it is to be used for one to four months, but experience has shown that results take much longer. It is a systemic drug, meaning it will travel throughout the body and remote areas will be affected. The depigmentation generally occurs as a gradual lightening of the skin, not as new spots of vitiligo.

[What is Benoquin?]

Generic Name: MonobenzoneDosage Form: cream, USPMonobenzone is the monobenzyl ether of hydroquinone. Monobenzone occurs as a white, almost tasteless crystalline powder, soluble in alcohol and practically insoluble in water.
Chemically, monobenzone is designated as p-(benzyloxy) phenol; the empirical formula is C13H12O2; molecular weight 200.24. The structural formula is:

C13H12O2   200.24

Each gram of Benoquin Cream contains 200 mg of monobenzone USP, in a water-washable base consisting of purified water USP, cetyl alcohol NF, propylene glycol USP, sodium lauryl sulfate NF and white wax NF.

Benoquin - Clinical PharmacologyBenoquin Cream 20% is a depigmenting agent whose mechanism of action is not fully understood.

The topical application of monobenzone in animals, increases the excretion of melanin from the melanocytes. The same action is thought to be responsible for the depigmenting effect of the drug in humans. Monobenzone may cause destruction of melanocytes and permanent depigmentation.

This effect is erratic and may take one to four months to occur while existing melanin is lost with normal sloughing of the stratum corneum. Hyperpigmented skin appears to fade more rapidly than does normal skin, and exposure to sunlight reduces the depigmenting effect of the drug. The histology of the skin after depigmentation with topical monobenzone is the same as that seen in vitiligo; the epidermis is normal except for the absence of identifiable melanocytes.

[Depigmentation is permantent?]

It’s hard to say yes or not due everybody systems react different. but in most cases, yes. Some people do experience some repigmentation or freckling due to sun exposure, which can be reversed by using monobenzone on those areas again.

[Are they any side Effects?]

Depigmentation is not natural in most of the cases, so to start depigmenting you need a drug called Benoquin [Monobenzone] and the side effects could be: Dry skin, burning, irritation, redness, cracking or peeling of the skin may occur. If any of these effects persist or worsen, notify your doctor. Tell your doctor immediately if any of these serious side effects occur: rash, swelling, skin discoloration of areas not treated with this medication. If you notice other effects not listed above, contact your doctor or pharmacist. other side effects: the skin will be permanently sensitive to sunlight, the person will not tan and allergic reactions could happen in some cases.

[How long does depigmentation take?]

It’s very hard to give an exaclty time frame but on average about 1-2 years, it can take more or less time depending on how extensive the vitiligo is to begin with and how light or dark skinned the person is.

[How much does it cost?]

Can’t tell a exaclty number all depending your pharmacy seller and if your insurrance will cover it or not. It’s an expensive treatment that could take years to be totally completed. so expect to spend from $100-$400 a month.

[Do I need a prescription for Benoquin (Monobenzone)?]

Absolutly yes! Most doctors follow the guideline that a patient must be at least 50% involved with vitiligo before beginning depigmentation therapy. However, some doctors will prescribe monobenzone for those with lesser amounts of vitiligo if the existing vitiligo is concentrated in visible areas and is causing the patient considerable distress. Honestly all depends if your really ready for depigmentation and together finding a doctor who can really understand you. some doctors are so hesitant in prescribing monobenzone because its a permanent change to a persons appearance that can have a social and cultural effect.