Skin lightening

Dear Alice,

Are there any pills or medicines available which could whiten overall complexion? If so, are they safe to use?

Dear Reader,

The truth is, skin lightening products can be pose risks to a person’s health. Whether there’s a desire to lighten overall skin tone or even out complexion, be warned — skin lightening creams haven’t been approved for any medical purpose by the United States Food and Drug Administration (FDA) and aren’t well-regulated. Typically, they’re designed to treat uneven skin tone from age spots, freckles, blemishes, hyperpigmentation (excessive pigmentation), hypopigmentation (insufficient pigmentation), or acne. Others may choose to use them so their skin will meet cultural or societal expectations. Thus, for those interested in these types of products, considering the reasons for seeking out skin lightening and speaking with a dermatologist (skin specialist) can help determine what options may be most appropriate and pose the lowest health risks.

Before jumping into the types of skin lightening products that are available, first you may want to consider a little self-reflection: Why do you want to lighten your skin? Do you want to lighten your overall complexion? Do you want to even out your complexion? What, if any, cultural or societal influences are you considering when making this decision? Do you believe it will improve your attractiveness or self-esteem? Knowing the answers to these questions may provide a place to start.

For those who decide to pursue skin lightening, there are some considerations to be made. And it bears repeating, consulting with a medical professional first is wise. For example, those with dark spots and uneven skin tone, opting to wait until the discoloration fades may be a place to start, as the skin cells that carry melanin (color pigments in the skin) are constantly being regenerated and sloughed off. However, full fading may take six to twelve months and discoloration deeper within the skin can take longer. If this wait seems too long, the process might be sped up using over-the-counter (OTC) or prescription skin lightening creams. Popular prescription creams include hydroquinone combined with tretinoin, though it’s not recommended they be used for longer than a month. Other OTC options include ones that contain two percent hydroquinone, azelaic acid, glycolic acid, kojic acid, retinoid, or vitamin C. While using these medications, using sunscreen with a sun protection factor (SPF) of 30 or higher (even during rainy or cloudy days) is advised as sun exposure can darken any discoloration and prolong fading time.

And buyer beware: for OTC products, it’s been noted that many of the product labels don’t adequately indicate the high level of toxic ingredients in the product and some completely fail to do so. Even skin lightening creams that do list ingredients may not disclose each one, sometimes resulting in undesirable side effects. Some common ingredients to be wary of include:  

  • Mercuric chloride: It’s readily absorbed through the skin and can result in mercury poisoning. Additionally, mercuric chloride can cause pimples, rashes, permanent discoloration, burning pain, neurological damage, and kidney damage. Due to its harmful nature, it has been banned for use in skincare products in some countries.
  • Clobetasol propionate: This is a strong topical steroid, which can only be prescribed by dermatologists at 0.05 percent strength. However, it’s never been approved for use on the face or as a skin lightening ingredient, as it can cause depigmentation. Some signs and symptoms of overuse include thinning of skin, increased appetite and weight gain, acne, and deposits of fat around the chest, face, back, and stomach.
  • Hydroquinone: This ingredient interrupts the production of melanin. It’s considered a carcinogenic and hepatotoxic (damaging to liver cells) substance and has been banned in Canada and throughout the European Union. While the U.S. allows for concentrations of 1.5 percent to 2 percent to be sold, bootleg versions have been found to contain up to 5 percent. Misuse can cause a bluish-black darkening of the skin.

Rest assured, Reader, that these products are not the end all be all — there are natural ingredients that may help treat hyperpigmentation by either promoting skin-lightening or preventing skin-darkening. While these products contain natural ingredients, it’s good to know that they may also result in skin irritation or allergic. These include:

  • Soy: This legume is commonly found in moisturizers and can inhibit the transfer of melanosome (pigment) to the skin, preventing skin-darkening.
  • Ellagic acid: This natural antioxidant comes from strawberries, cherries, and pomegranates and inhibits an enzyme needed for melanin production, thereby preventing skin-darkening.
  • Arbutin: This natural derivative of hydroquinone is produced from bearberry, blueberry, and cranberry plants. Some OTC cosmetic products contain three percent concentrations of this acid, which studies show can significantly lighten skin.
  • Kojic acid: This antioxidant comes from fungus, and it works by breaking down and preventing further production of melanin in the skin. It can be found in products in 1 to 4 percent concentrations, either by itself or with other skin-lightening agents. Research has found it to be effective as a skin-lightening ingredient.
  • Liquiritin: This derivative of the licorice root is available OTC and has been found to lighten skin by inhibiting melanin production.

Adapted from the American Academy of Dermatology.

No matter the product, it bears repeating that speaking with a dermatologist before using any skin lightening products is wise, as they can make recommendations on the ones that are most effective and safest for a given skin type or condition. And, ultimately, while these skin lightening products may help change skin color and appearance, there are certainly pros and cons to consider. It’s possible that instead of heading to the cosmetic aisle or medical office, some initial self-reflection may lead to a pursuit of self-acceptance.

Last updated Oct 20, 2017
Originally published Jan 13, 2012

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