A skin-lightening cream, hailed by many officials' wives as a savior for rescuing their complexion, can turn into a "beauty killer" if used improperly. A woman in Taichung City developed systemic vitiligo after using a skin-lightening cream locally for a year and a half. Shen Rui-long, director of dermatology at Taichung Veterans General Hospital, pointed out that many skin-lightening creams contain the bleaching agent hydroquinone, which works by inhibiting melanin formation. Vitiligo caused by this ingredient often resolves on its own, though the duration varies from person to person. If the condition does not revert, ultraviolet light therapy is required, and sun exposure must be avoided.

The 34-year-old woman originally had a few dark patches on her forehead and lower neck. A well-meaning colleague gave her a skin-lightening cream produced by their family. After daily application, her condition slightly improved, so she began mixing the cream with moisturizer and applying it to her body. Shen Rui-long noted that the areas she applied the cream—mainly her forehead, hairline, lower neck, and shoulders—developed white patches. A biopsy confirmed that the vitiligo was caused by the skin-lightening cream.

The patient's skin was already fair, and the areas where she applied the cream were covered by clothing, which delayed the discovery of the cream's harmful effects. Shen Rui-long explained that many creams and skincare products claiming to have skin-lightening effects contain hydroquinone. For example, a popular triple-action skin-lightening cream containing "tretinoin (0.03%), a steroid compound (0.03%), and hydroquinone (4-5%)" includes this ingredient.

Clinically, hydroquinone is used to treat hyperpigmentation conditions such as melasma, freckles, and post-inflammatory hyperpigmentation. However, improper use can lead to side effects like erythema, vitiligo, burns, and dermatitis. Vitiligo caused by hydroquinone is characterized by indistinct boundaries and may be accompanied by rashes, scaling, and a history of contact. This patient used the cream for a year and a half, and after stopping, she developed well-defined vitiligo patches all over her body, a rare clinical occurrence.

Many people believe that using more skin-lightening cream will yield faster and better results, but this is incorrect. Shen Rui-long noted that many countries regulate the use of hydroquinone or replace it with ingredients like arbutin and magnesium ascorbyl phosphate. Taiwan has no such restrictions, and due to its affordability, availability, and quick effects, many beauty industry professionals use it. However, because products containing this ingredient carry certain risks, it is best to use them under a doctor's supervision to avoid adverse effects.