Skin whitening
Skin whitening, also known as skin lightening and skin bleaching, is the practice of using chemical substances in an attempt to lighten the skin or provide an even skin color by reducing the melanin concentration in the skin. Several chemicals have been shown to be effective in skin whitening, while some have proven to be toxic or have questionable safety profiles. This includes mercury compounds which may cause neurological problems and kidney problems.
In a number of African countries, between 25% and 80% of women regularly use skin-whitening products. In Asia, this number is around 40%. In India, over 50% of skin-care product sales are attributed to skin-lightening formulations. In Pakistan, where skin lightening products are popular, creams have been found to contain toxic levels of hydroquinone and mercury.
Efforts to lighten the skin date back to at least the 16th century in Asia. While a number of agents — such as kojic acid and alpha hydroxy acid — are allowed in cosmetics in Europe, a number of others such as hydroquinone and tretinoin are not. While some countries do not allow mercury compounds in cosmetics, others still do, and they can be purchased online.
Use
Areas of increased pigmentation such as moles may be depigmented to match the surrounding skin. Effective agents for specific areas include corticosteroids, tretinoin, and hydroquinone. These agents are not allowed in cosmetics in Europe due to concerns about side effects. Attempts to whiten large areas of skin may also be carried out by certain cultures. This may be done for reasons of appearance, politics, or economics.Skin whiteners can help achieve lighter skin tones, but many of them contain harmful ingredients, such as the steroid clobetasol propionate, inorganic mercury, glutathione, and the organic compound hydroquinone. Skin lighteners' main health risks are linked to The overuse of topical clobetasol, which can cause systemic steroid effects from daily usage, especially on broad skin regions; and concealed mercury content, which can lead to mercury poisoning depending on individual susceptibility. Many skin whiteners contain a toxic form of mercury as the active ingredient. Their use, therefore, may harm a person's health and is illegal in many countries.
Types
- Hydroquinone is a commonly used agent in skin whiteners. The European Union banned it from cosmetics in 2000. It works by decreasing melanin production.
- Tretinoin, also known as all-trans retinoic acid, may be used to whiten specific areas. It may be used in combination with steroids and hydroquinone.
- Alpha hydroxy acid is used as a skin bleacher. Its biochemical mechanism is unclear. Side effects may include sun sensitivity, skin redness, thickening, or itching. Low concentrations may be used in cosmetics.
- Kojic acid has been found to be an effective lightener in some studies and is also allowed to be used in cosmetics. Side effects include redness and eczema.
- Glutathione is the most common agent taken by mouth to whiten the skin. It can be used as a cream. It is an antioxidant normally made by the body. Whether or not it actually works is unclear as of 2019. Due to side effects that may result from intravenous use, the government of the Philippines recommends against such use.
- One 2017 review found tentative evidence of benefit of tranexamic acid in melasma. Another 2017 review found that evidence to support its use was insufficient.
- Azelaic acid may be a second-line option for melasma.
- Decapaptide-12 and related peptides which act as tyrosinase inhibitors have been used as skin-lightening agents.
- A number of types of laser treatments have been used in melasma with some evidence of benefit. Reoccurrence is common, and certain types of lasers can result in more pigmentation.
Side effects
Prolonged usage of mercury-based products can ultimately discolor the skin, as mercury will accumulate within the dermis. Mercury toxicity can cause acute symptoms such as pneumonitis and gastric irritation. However, according to a study by Antoine Mahé and his colleagues, mercurial compounds can also contribute to long-term renal and neurological complications, the latter of which includes insomnia, memory loss, and irritability.
Other studies have explored the impact of hydroquinone exposure on health. Hydroquinone rapidly absorbs into the body via dermal contact; long-term usage has been found to cause nephrotoxicity and benzene-induced leukemia in the bone marrow. A study by Pascal del Giudice and Pinier Yves indicated that hydroquinone usage is strongly correlated with the development of ochronosis, cataracts, patchy depigmentation, and contact dermatitis. Ochronosis can lead to lesions and squamous cell carcinomas. While hydroquinone has not been officially classified as a carcinogen, it can metabolize into carcinogenic derivatives and induce genetic changes in the form of DNA damages.
Corticosteroids have become some of the most commonly incorporated lightening agents. Long-term usage over large areas of skin may promote percutaneous absorption, which can produce complications such as skin atrophy and fragility, glaucoma, cataracts, edemas, osteoporosis, menstrual irregularities, and growth suppression. A 2000 study performed in Dakar, Senegal, indicated that chronic usage of skin lighteners was a risk factor for hypertension and diabetes.
Chemically lightened skin is more highly susceptible to sun damage and dermal infection. Long-term users of skin bleachers can easily develop fungal infections and viral warts. Pregnant users may also experience health complications for both them and their children.
Rate of usage
In 2013, 77% of Nigerian women, 52% of Senegalese women, and 25% of Malian women were using lightening products. In 2020, Der Spiegel reported that in Ghana, "When You Are Light-Skinned, You Earn More", and that "ome pregnant women take tablets in the hopes that it will lead their child to be born with fair skin. Some apply bleaching lotion to their babies, in the hopes that it will improve their child's chances."Skin whiteners typically range widely in pricing. Olumide attributes this to the desire to portray whitening as financially accessible to all. These products are marketed to both men and women, though studies indicate that, in Africa, women use skin bleachers more than men do. A study by Lester Davids and his colleagues indicated that nations in Africa present high rates of usage for skin bleachers. Though many products have been banned due to toxic chemical compositions, Davids found that regulating policies are often not strictly enforced.
In India, the sales of skin lightening creams in 2012 totaled around 258 tons, and in 2013 sales were about US$300 million. By 2018, the industry for lightening cosmetics in India had achieved a net worth of nearly $180 million and an annual growth rate of 15%. As of 2013, the global market for skin lighteners was projected to reach $19.8 billion by 2018, based on sales growth primarily in Africa, Asia, and the Middle East.
In the United Kingdom, many skin whiteners are illegal due to possible adverse effects. Such products are frequently still sold even after shops have been prosecuted. Trading standards departments lack the resources to deal with the problem effectively.
Motivations
According to Yetunde Mercy Olumide, advertisements for skin lighteners often present their products as stepping stones to attain greater social capital. For example, representatives of India's Glow & Lovely cosmetics asserted that their products allowed for socioeconomic mobility, akin to education.In some parts of Africa, people with lighter skin are thought to be more attractive and likely to find more financial success than those with darker skin tones.
In 2009, historian Evelyn Nakano Glenn attributed sensitivities to skin tone among African Americans to the history of slavery. Lighter-skinned African Americans were perceived to be more intelligent and skilled than dark-skinned African Americans, who were relegated to more physically taxing, manual labor.
Studies have linked paler skin to achieving increased social standing and social mobility. A 2011 study found that in Tanzania, residents choose to bleach their skin to appear more European and impress peers and potential partners. Both advertisements and consumers have suggested that whiter skin can enhance individual sexual attractiveness. In 2011, sociologist Margaret Hunter noted the influence of mass-marketing and celebrity culture emphasizing whiteness as an ideal of beauty. A 2018 study found that lighter skin tones in both men and women in India improved their prospects for marriage.
Skin whitening is practiced by some people in several parts of Asia. In South Korea, light skin is generally considered to be an ideal of beauty. The K-pop and K-drama industries are generally saturated with fair-skinned celebrities, some of whom serve as brand ambassadors and beauty ideals.
The increasing popularity of South Korean culture and K-beauty has
been a factor in popularizing the skin whitening trend elsewhere in Asia, especially in poorer countries like Thailand, where many have begun to use unsafe skin-whitening products. In Nepal, cultural influence from Bollywood, which prominently features lighter skinned lead actors, has been linked to the use of skin whitening creams among some darker-skinned men.
Other motivations for skin whitening include desiring softer skin and wanting to conceal discolorations arising from pimples, rashes, or chronic skin conditions. Individuals with depigmenting conditions such as vitiligo have also been known to lighten their skin to achieve an even skin tone.