What is the proper usage of Monobenzone (Benzoquinone) for treating vitiligo?

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From the Guidelines

Monobenzone should be used for vitiligo only when a patient has extensive vitiligo (more than 50% of body surface affected) and wants to achieve uniform depigmentation of remaining normal skin, as recommended by the British Journal of Dermatology guidelines 1.

Key Considerations

  • The treatment should be reserved for adults who cannot or choose not to seek repigmentation and who can accept the permanence of never tanning 1.
  • Apply a thin layer of 20% monobenzone cream to the normally pigmented areas twice daily, avoiding contact with unaffected individuals as it can transfer and cause depigmentation in others.
  • Treatment should continue until desired depigmentation is achieved, which typically takes 1-12 months, and results are permanent.
  • Sun protection is essential during and after treatment as depigmented skin is highly susceptible to sunburn and skin cancer.
  • Monobenzone works by destroying melanocytes (pigment-producing cells), unlike other vitiligo treatments that aim to restore pigmentation.

Important Precautions

  • This treatment should only be used under dermatologist supervision as it causes irreversible depigmentation and is considered when other repigmentation therapies have failed.
  • Side effects may include skin irritation, contact dermatitis, and ocular complications if used near the eyes.
  • Patient selection is crucial, and it is vital that patients with a dark skin type understand the cultural implications of depigmentation treatment 1.
  • Depigmentation is generally undertaken only when the patient has more than 50% pigment loss in their skin due to vitiligo, or when the depigmentation is extensive in the cosmetically sensitive areas of the hands and face 1.

From the Research

Usage of Monobenzone for Vitiligo

  • Monobenzone is used for the depigmentation therapy of patients with extensive vitiligo, where the normally pigmented areas surrounding vitiligo lesions are depigmented to achieve a uniform skin tone 2.
  • The treatment involves applying monobenzone to the affected areas, and it has been shown to be effective in producing a complete degree of depigmentation in some cases 3.
  • However, the use of monobenzone is limited due to its permanent and potent nature, and it can cause side effects such as corneal and conjunctival effects 4.

Application and Dosage

  • The exact dosage and application instructions for monobenzone are not specified in the provided studies, but it is mentioned that a combination of monobenzone with retinoic acid can enhance its depigmenting effects 2.
  • It is essential to follow the instructions of a healthcare professional when using monobenzone, as it can have serious side effects if not used properly.

Alternative Treatments

  • Other treatments for vitiligo include phototherapy, which has been shown to be effective in achieving repigmentation in some patients 5.
  • Emerging treatments for vitiligo are being developed, and clinicians should be aware of the available options and their potential benefits and risks 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Successful treatment of extensive vitiligo with monobenzone.

The Journal of clinical and aesthetic dermatology, 2012

Research

Corneal and conjunctival effects of monobenzone in patients with vitiligo.

Archives of ophthalmology (Chicago, Ill. : 1960), 1983

Research

Current and emerging treatments for vitiligo.

Journal of the American Academy of Dermatology, 2017

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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