Skin Lighteners & Whitening of the Skin Complexion

Skin lighteners (bleaching or whitening creams) are a commonly used cosmetic product among men and women looking for a lighter skin complexion (‘fair skin’) for aesthetic purposes. Cultural misconceptions and personal beliefs about the appeal of a lighter skin complexion have made these creams, soaps and lotions a popular beauty product in Asia and Africa among darker skinned ethnic groups. A lack of appropriate regulation in many developing countries allows for these products to be sold over-the-counter although it contains pharmacologically active and toxic compounds like hydroquinones, corticosteroids and mercury.

Natural Skin Pigmentation

Melanin is a brown pigment produced by the melanocytes (melanin forming cells) in the deeper layers of the skin. The function of melanin is to absorb harmful ultraviolet (UV) rays from the sun and protects the skin from diseases such as cancer. The distribution of melanin differs among  individuals and is influenced by genetics (familial and racial). Hormonal disturbances such as pregnancy or menopause may cause conditions such as melasma, where the skin may appear hyperpigmented (dark patches) in certain areas. In these cases, the use of skin lighteners may assist to ‘even out’ pigmentation and blend these areas with the natural skin tone.

The effect of skin lighteners differs among individuals as it is dependent on:

1. The individual skin type (dry, dehydrated or oily).
2. The condition being treated (sun damage, pigmentation in pregnancy, damage from cosmetic products such as steroid creams).
3. The concentration or strength of the active ingredients.
4. The period of time during which the skin lightener was used.

Ingredients in Skin Lightening, Whitening & Bleaching Products

Hydroquinones (often misspelled as ‘hydroquinine’) is by far the most common ingredient in these skin lightening products. The bleaching effect of hydroquinones has been widely known for many decades and has been banned as a cosmetic product in many developed countries. Pharmaceutical applications include the treatment of certain hyperpigmentation disorders, like melasma, damage caused by skin sun sensitivity or photodermatosis, blemishes, freckles and age spots. Other common ingredients in cosmetic skin lightening products include hydrocortisone (’steroid cream’) and mercury, both of which have a host of side effects if used over long periods of time.

Hydroquinone

Although hydroquinone is widely used in skin bleaching cosmetic products in Africa and Asia, it is banned in Europe due to its side effects. Hydroquinone is a toxic chemical that is also used in the processing of photographs and the manufacture of rubber and hair dyes. The side effects of hydroquinone include:

• Thinning of the skin which affects the collagen fibers.
• Due to the damage of collagen fibres pre-mature wrinkling can develop.
• Hydroquinone can cause irritation to the skin as it is an unstable ingredient.
• Blistering or cracking of the skin can often result with long term use.
• Prolonged use of hydroquinone can cause grey or bluish black pigmentation.
• Impaired wound healing which can result in recurrent or chronic skin infections.
• Hydroquinone can cause cancer as it inhibits the production of melanin thereby ‘robbing’ the skin of its natural UV protection capabilities.

Mercury

Mercury which is the second common ingredient used in skin lighteners is derived from mercury chloride and is a carcinogen. The side effect of mercury includes:

• An increased risk of cancer as the skin has no protection from the sun.
• Damage of the skin connective tissue.
• A rough blotchy skin with a spotty appearance.
• Mercury poisoning as it accumulates in the skin cells and enters the blood stream.
• Dryness of the skin as moisture is depleted from the skin cells.
• Ulceration of the skin.

Corticosteroid or Hydrocortisone

Steroids which is another widely used ingredient used in skin lighteners and is an effective but dangerous compound. Fortunately, the use of corticosteroids in cosmetic products is being restricted in many countries due to its classification as a pharmaceutical. The side effects of long term topical corticosteroid use includes :

• Thinning of the skin
• Appearance of pale and dark ‘lines’ similar to stretch marks
• The skin may become prone to bacterial and fungal infections, dermatitis and systemic conditions like Cushing’s syndrome could occur.
• Pre-existing conditions like eczema and acne may ease with ’steroid’ use but will often return and aggravate over time or once the cream is discontinued.