Benoquin Cream

Benoquin Cream 20% is indicated for final depigmentation in extensive Vitiligo. Benoquin Cream 20% is applied topically to permanently depigment normal skin surrounding vitiliginous lesions in patients with disseminated (greater than 50 percent of body surface area) idiopathic vitiligo. Benoquin is not recommended in freckling; hyperpigmentation caused by photosensitization following the use of certain perfumes (berlock dermatitis); melasma (chloasma) of pregnancy; or hyperpigmentation resulting from inflammation of the skin.

Product dosage: 20 gr
Package (num)	Per tube	Price	Buy
1	$73.00	$73.00 (0%)	🛒 Add to cart
2	$67.50	$146.00 $135.00 (8%)	🛒 Add to cart
4	$64.25	$292.00 $257.00 (12%)	🛒 Add to cart
8	$62.88 Best per tube	$584.00 $503.00 (14%)	🛒 Add to cart
Synonyms Monobenzone Cream Benoquin

Benoquin Cream (monobenzone 20%) is a prescription-grade topical depigmenting agent indicated for the permanent lightening of hyperpigmented skin in vitiligo patients with extensive, recalcitrant disease. It functions by selectively destroying melanocytes, resulting in irreversible depigmentation. This monograph provides a comprehensive, evidence-based overview for healthcare professionals to ensure safe and effective therapeutic application. Its use requires careful patient selection, thorough counseling, and diligent monitoring due to its permanent and potent mechanism of action.

Features

• Active Ingredient: Monobenzone 20% (monobenzyl ether of hydroquinone).
• Formulation: Oil-in-water emulsion cream base for optimized cutaneous delivery.
• Concentration: High-potency, prescription-only formulation.
• Action: Cytotoxic to melanocytes via generation of reactive quinones and disruption of melanosomal integrity.
• Permanence: Induces irreversible depigmentation; reversal is not possible.
• Packaging: Typically supplied in air-tight tubes to prevent oxidation of the active compound.

Benefits

• Achieves permanent, uniform depigmentation in patients with extensive vitiligo (>50% body surface area), eliminating the stark contrast between pigmented and depigmented skin.
• Provides a definitive cosmetic solution for individuals who are not candidates for repigmentation therapies and seek a consistent skin tone.
• Reduces the psychological burden and social stigma associated with widespread, visible vitiligo by offering a controllable outcome.
• Minimizes the need for ongoing, often ineffective, topical treatments aimed at repigmentation.
• The treatment endpoint is clear and definitive, allowing patients to conclude active management.
• When applied correctly under supervision, it can yield a predictable and aesthetically acceptable result.

Common use

Benoquin Cream is exclusively indicated for the permanent depigmentation of the remaining pigmented skin in adult patients with extensive, widespread, and recalcitrant vitiligo. It is not a first-line treatment and is reserved for cases where repigmentation therapies have repeatedly failed or are deemed impractical due to the extent of involvement. Its primary use is to create a uniform, depigmented appearance across the entire integumentary system. It is critically important to note that this product is absolutely not intended for the treatment of melasma, post-inflammatory hyperpigmentation, solar lentigines, or any other localized hyperpigmentary disorder. Misuse for these conditions will result in permanent, irregular, and cosmetically disastrous depigmentation.

Dosage and direction

Application must be strictly supervised by a dermatologist. The following protocol is standard:

1. Test Application: Prior to full-scale treatment, a 24-hour occlusive patch test must be performed on a small, discreet area of pigmented skin (e.g., behind the ear) to check for severe irritation or contact hypersensitivity.
2. Initial Phase: Apply a thin layer of cream to a small area of pigmented skin (e.g., a 5x5 cm patch on the face) twice daily. Do not apply to already depigmented areas.
3. Gradual Expansion: If tolerated after 2-4 weeks, gradually increase the treatment area every 1-2 weeks. The process of complete depigmentation is slow, often taking 6-24 months.
4. Application Technique: Wash and dry hands before and after application. Apply to completely dry skin. Gently rub in until absorbed.
5. Frequency: Apply twice daily, approximately every 8-12 hours. Consistency is paramount for uniform results.
6. Post-Depigmentation: Once full depigmentation is achieved, application must cease immediately. Permanent sun protection is mandatory thereafter.

Precautions

• For External Use Only: Avoid contact with eyes, eyelids, lips, and mucous membranes. If contact occurs, rinse thoroughly with water.
• Sun Exposure: Treated skin will be permanently photosensitive. Patients must use a broad-spectrum sunscreen with a high SPF (50+) and wear protective clothing for life. Sunburn must be scrupulously avoided.
• Irritation: Mild erythema and scaling are common initially. Severe irritation, burning, or itching may indicate hypersensitivity and require discontinuation.
• Permanence: Patients must be extensively counseled that depigmentation is irreversible. They will have permanently white skin and lifelong sun sensitivity.
• Uneven Application: Inconsistent application can lead to a speckled or blotchy appearance. Meticulous technique is required.
• Occupational Hazards: Counsel patients whose jobs involve significant sun exposure about the implications of permanent photosensitivity.

Contraindications

Benoquin Cream is contraindicated in patients with:

• A known hypersensitivity to monobenzone, hydroquinone, or any other component of the formulation.
• Localized hyperpigmentary conditions (e.g., melasma, chloasma, post-inflammatory hyperpigmentation, solar lentigines).
• A history of melanoma or dysplastic nevus syndrome.
• Pre-existing non-vitiligo related depigmentation disorders.
• Children and adolescents under the age of 18.
• Pregnancy and lactation: Category C. Animal studies have shown adverse effects. There are no adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus. It is not known if monobenzone is excreted in human milk. A decision should be made to discontinue nursing or discontinue the drug.

Possible side effect

• Very Common (>10%): Application site reactions including erythema (redness), dryness, fissuring, and pruritus (itching).
• Common (1-10%): Contact dermatitis, burning sensation, swelling.
• Uncommon (<1%): Speckled depigmentation (if applied unevenly), halo dermatitis (eczematous reaction surrounding treated areas).
• Rare: Systemic effects are extremely rare with topical use but could theoretically occur with application to a very large body surface area on broken skin, potentially leading to ochronosis (blue-black discoloration) or nephrotic syndrome, though this is poorly documented.

Drug interaction

Formal interaction studies have not been conducted. However, theoretical interactions exist:

• Other Topical Agents: Concomitant use with other topical medications, especially those with irritant or drying properties (e.g., retinoids, benzoyl peroxide, alcohol-based products, abrasive scrubs), may significantly increase cutaneous irritation. A staggered application schedule (e.g., AM/PM) should be considered if combination therapy is unavoidable.
• Photosensitizing Agents: Use with other systemic or topical drugs known to cause photosensitivity (e.g., tetracyclines, thiazides, phenothiazines, fluoroquinolones, topical retinoids) may have an additive effect, increasing the risk of severe sunburn.

Missed dose

If a dose is missed, apply it as soon as remembered. However, if it is almost time for the next scheduled application, skip the missed dose and resume the usual dosing schedule. Do not apply a double dose to compensate for a missed one. Consistency is important for uniform results, but occasional missed doses are unlikely to significantly impact the long-term outcome.

Overdose

Topical overdose would manifest as a severe local skin reaction, including intense erythema, burning, pruritus, edema, and possibly blistering or weeping. Systemic absorption through intact skin is minimal, but application to large areas of broken or inflamed skin could theoretically increase absorption, potentially leading to systemic toxicity (e.g., nephropathy). Treatment involves immediate discontinuation of the cream, removal of any residual product by washing, and symptomatic management of the skin reaction (e.g., cool compresses, topical corticosteroids). There is no specific antidote.

Storage

• Store at controlled room temperature, 20°C to 25°C (68°F to 77°F). Excursions are permitted between 15°C and 30°C (59°F and 86°F).
• Keep the tube tightly closed when not in use to prevent oxidation and degradation of the active ingredient.
• Keep away from direct sunlight, heat, and moisture (e.g., do not store in a bathroom).
• Keep out of reach of children and pets.

Disclaimer

This information is intended for educational purposes and for use by qualified healthcare professionals only. It is not a substitute for professional medical advice, diagnosis, or treatment. The content provided is based on current medical literature and product labeling but may not be exhaustive. Always seek the advice of a qualified physician or dermatologist with any questions you may have regarding a medical condition or before commencing or altering any treatment regimen. Never disregard professional medical advice or delay in seeking it because of something you have read here. The author and publisher are not responsible for any errors or omissions or for any consequences from the application of this information.

Reviews

“After struggling with over 80% body surface area vitiligo for two decades and failing every repigmentation therapy, Benoquin was a last resort. The process was long and required extreme discipline with sun protection, but achieving a uniform skin tone has been life-changing for my confidence. The counseling from my dermatologist was critical.” - Patient M.C., treated under dermatological supervision for 14 months.

“Prescribing Benoquin requires the most rigorous patient selection and informed consent process in my practice. It is not a decision to be taken lightly. For the appropriate patient—one with extensive, treatment-resistant vitiligo who is fully aware of the permanence and sun-protection commitment—it can be an incredibly powerful tool to restore a sense of normalcy and control.” - Dr. A. Sharma, Board-Certified Dermatologist.

“The initial irritation was significant for me, and the twice-daily application routine was demanding. However, my dermatologist managed the irritation with brief rest periods and a gentle skincare regimen. Seeing the pigmented patches slowly fade and blend was worth the effort. The key is patience and strict adherence to the instructions.” - Patient J.L.

“From a clinical perspective, Benoquin is a uniquely powerful agent. Its mechanism is fundamentally destructive, which is why its use must be confined to the specific indication of extensive vitiligo. We monitor our patients monthly for adherence, uniform application, and skin health. The outcomes, when done correctly, are definitive and patient satisfaction among this specific cohort is very high.” - Dr. K. Ito, Clinical Research Dermatologist.