Would you use a cream or soap that may have the following long-term side effects – skin cancer, liver damage, kidney damage or poisoning?

Skin lightening or whitening is a controversial topic as it is closely intertwined with the detrimental effects on health, identity, self-image, racial supremacy and colonial mentality. There is evidence to suggest that some active ingredients used in publicly available skin-whitening products can be harmful.

In the modern appearance conscious society in which we live, especially in Asia, Africa and other continents which were at one time controlled by ‘whiter’ races, there is a myth that lighter paler complexions portray beauty, riches and success. This misguided belief has resulted in a huge market in the world of skin lightening products. Some people use them secretly knowing what the side effects are, others use poorly labeled over the counter products not knowing what dangers they are letting themselves in for. Manufacturers may not be fully versed with the side effects or labeling may be misleading or economical with the truth.

For years, people have been heard to snicker about Michael Jackson’s feeble attempts to “be more white.” The truth is, Michael Jackson’s skin is white because more than a decade ago, he used powerful skin-lightening medication to blend his naturally brown skin color with his white, depigmented patches. Skin-lightening creams are heavily promoted by many Dermatologists and Skin care experts to even out cosmetic conditions like vitiligo, liver spots, and other superficial blemishes. The problem with these creams is that many of them contain a substance called hydroquinone, which a variety of studies have linked to:

  • Increased risk of cancer
  • Increased risk of adrenal gland problems
  • Increased risk of all health conditions associated with mercury poisoning
  • Increased risk of developing a rare metabolic disorder called ochronosis, which can cause physical changes to the skin and tissues surrounding the eyes, ears, and joints

Citing these and other potential dangers of using creams that contain hydroquinone, the Food and Drug Administration in the U.S. put forth a proposal to ban over-the-counter sales of skin-lightening products. If you’re not convinced that skin-lightening products that contain hydroquinone are best avoided, consider that hydroquinone has also been banned for sale in the European Union, Australia, and Japan, amongst other countries as an over-the-counter (without prescription) ingredient.

According to the L.A. Times, in the United States, approximately two-thirds of all skin-lightening products are available over-the-counter without a prescription. Who knows how many millions of dollars this translates to each month for companies that produce these products? In Asia, Skin rejuvenation is an even bigger market – India, Singapore, China and Malaysia have shown almost 100% increase in sales every year for the past five years and are the largest single group of cosmetics sold in these countries.

The Color in our Skins

Why do we have colour in our skin?

There are three reasons for the colour of our skin:

o The cells contained within the dermis and epidermis provide a natural yellow, white colour

o Superficial blood vessels provide a blue or red tint determined by oxygen content

o Melanin produced by melanocytes scattered within the basal layer of the skin

It is this third point which determines how dark a person’s skin is; more melanin production results in darker skin. Melanin has another key function – it plays a major protective role. It is the skins own natural protection from the harmful ultra violet rays of the sun. Without it, the skin is extremely vulnerable and we would have to cover exposed skins with sun screen or risk a greater chance of developing skin cancer.

How skin lightening products work

There are two main chemicals found in most skin lightening products, Hydroquinone or Mercury.

o Hydroquinone (C6H6O2) is a severely toxic and very powerful chemical used in photo processing, the manufacture of rubber and is an active agent in hair dyes.

o Mercury in the form of Mercury Chloride & Ammoniated Mercury is carcinogenic. They appear on the list of toxic substances that can only be purchased via pharmacies with prescribed labels of toxicity.

Both products perform a similar process. In the short term they will initially cause the skin to lighten by inhibiting the production of melanin. Without melanin formation in the basal layer, no brown pigmentation will be visible. The long term effects, however, are those that must be addressed. The long term effects of using skin lightening products include the following:

Hydroquinone or Mercury applied to the skin in the longer term actually react with ultra violet rays and re-oxidise, leading to more pigmentation and premature ageing. More product is then applied in an attempt to correct the darker blotchy appearance. These are the beginnings of a vicious cycle. By altering the skins natural structure and inhibiting the production of Melanin, the skin’s natural protection, the skin is more susceptible to skin cancer. Prolonged use of Hydroquinone thickens collagen fibres damaging the connective tissues. The result is rough blotchy skin leaving it with a spotty appearance.

Mercury slowly accumulates within the skin cells striping the skin of its natural pigment leaving behind the tell tale signs of gray/ blue pigmentation in the folds of the skin. In the long term, the chemical can damage vital organs and lead to liver and kidney failure and mercury poisoning.

Are these products legal?

Products containing up to 2 percent Hydroquinone were legally available in the UK until 2001 when the Department of Trade and Industry (DTI) issued the draft 24th Commission Directive. This bans preparations with Hydroquinone due to the long term effects as it accumulates in the tissues. The UK Cosmetic Product Regulations 1978 prohibits the use of Mercury compounds.

However, the demand for these products is so high that there are illegal imports via small operators from Asia and Africa of creams, lotions and soaps of up to 6 percent which are sold over the counter, without a prescription, in the UK and the US.

This does not mean that you should never use hydroquinone, just that you should understand that this compound has deleterious effects and should never be used ‘lightly’ (pun unintended). Always use the same under prescription from a good dermatologist or plastic surgeon, if at all.

Second generation of skin lightening products

The story of Michael Jackson may be fascinating enough but one should be extremely careful before undergoing such techniques. There are other methods of whitening too. One should always prefer safer methods for whitening, if at all, by using safer alternatives to the toxic products.

Top 5 safe ingredients for skin whitening

Arbutin: It is considered to be a safe ingredient for external use because it does not have any side effects like unpleasant odor, toxicity or stimulation like Hydroquinone.

Vitamin C: It is an effective ingredient for preventing aging skin. It helps in synthesizing collagen in the body.

Licorice: This ingredient can easily inhibit UV-B induced pigmentation and other skin complications with ease.

Kojic Acid: It is one of the most important bleaching agents, which can easily inhibit the production of Melanin in our body. It can be included in the diet as well.

Vitamin A: This constituent should be used for treating damaged pelt complications such as vitiligo, hyper pigmentation, melasma, skin infection etc.

Ethical issues of skin lightening as a fad

For many years, beauty (especially in ‘colored’ countries) has been associated with being fair. My personal thought is that this mentality stems from being ruled by a white race for over 300 years. White skin has somehow become deeply associated in the Indian subconscious (for instance) with affluence and regality. The fact that most Indians tend to darken on exposure to sun means that there is a subconscious associative tendency between whiter skin and the probably lesser need to be exposed to the sun i.e. The subconscious associative tendency is that the richer one is, the whiter their skin is! Also, fair and beautiful are almost taken as synonymous of each other and these days, even fair and handsome! No less than a celebrity like Shah Rukh Khan or a Jennifer Lopez feel the need to tout the ‘advantages’ of being fair, in advertisements. Models are as white as possible and people are commended on the fairness of their skin. Those models who are not white are ‘airbrushed’ and lightened digitally! Even so-called celebrities feel the need to use foundation three shades lighter than their skin shade!

We feel that we must bow down to the social pressures and we suffer from the psychological effects of this social pressure which cause us to use products which may permanently disfigure or cause horrific side effects. It is sad and surprising that even in black people, there is racial discrimination – I have heard statements saying that Barrack Obama is the President of the United States as he is not “all that black” or that Halle Berry is an icon and a global sex symbol as she too is not all that black! Perhaps the real issue here is the lack of encouragement that our society offers to people who feel badly about their physical appearances. There never seems to be a shortage of Plastic surgeons, dermatologists, and other sales people who encourage people to change or hide what they don’t like about their looks.

Flip through any media columns dealing with the death of Michael Jackson and you are bound to come across the vitriol and scorn piled on him for his self-loathing, which saw him allegedly change his skin tone to white, and subject his body to the brutal scalpels of the extreme make-over vultures. What is missing from this tragic script is the uncomfortable truth about the persistently negative self-image of colored people, which emanates from a history which seems to have taught that white is better. What is missing is recognition of the role that skin-whitening creams and chemical-based hair products have played, and continue to play, in the lives of many colored people. Jackson constantly denied the use of skin bleaches, attributing his changing skin tone to a condition known as vitiligo, which causes patches of depigmentation. Media and entertainment pundits have presented the constant change in Jackson’s features as a freakish phenomenon, when, in truth, his constant battle with his blackness and his physical appearance should be placed in the context of a society – both black and white – which loathes itself. That society exists in a world which is happy to produce resources and products that allow us to change those features of ours that we dislike.

Cosmetic surgery is increasing at an alarming rate, in a society which seems to be embracing everything that we used to shun. Thousands of dark-skinned people across the globe spend copious amounts of money trying to change their skin tone or straighten their hair. Conversely, white people spend a sizeable amount of money frying themselves in the sun, or under tanning machines, risking their health to acquire a darker skin tone. The skin whitening products industry is a multibillion-dollar enterprise. Its marketers simply prey on the insecurity of people, particularly the negative self- image that many dark-skinned people carry around.

In South Africa, the Krok brothers, Abie and Solly, made a fortune off black people. Through their company, Twin Pharmaceutical Holdings, they held a big market share of the skin-whitening industry that turned many black skins into a kaleidoscope of colour, ranging from yellow to purple and leaving many women scarred and damaged for life. Ironically, until recently, these two owned the Apartheid Museum. They were also beneficiaries of an empowerment deal, through the acquisition of shares in Golf Reef City. The key products, which the brothers touted, were Super Rose, Ambi and He Man – Products which contained hydroquinone and mercury. Ask any man or woman who used these creams in the past, and they will tell you that these creams left them with more problems post use than they had before starting their use.

Many will claim that they ridicule Jackson because of the level to which he took the entire notion of whitening himself — literally changing his entire body. But to understand why anyone would want to go to such lengths, you need to have seen some of the “beneficiaries” of these products. The telltale signs of the Ambi “treatment” were there for all to see. The poor women could not put their hands to their faces because of the sharp contrast between the colour of their hands and their whitened faces. Many had to keep their necks covered for the same reason. In its worst stages, Ambi would leave indelible purple marks around their cheeks and eyes, which the women would have to cover with dark glasses.

History aside, as it cannot be solely to blame for the quest to be what we are not, skin-lightening products with hydroquinone are back on the market, despite being banned in many countries, including the UK, the US and South Africa. The wig, weaves and lighter colored contact lenses ­ which, for a while, were frowned upon as “trying to be white” — have resurfaced, with just about every celebrity and financially powerful human using them. The amount of money poured into cosmetic changes, and the general acceptance of such procedures, points to the fact that people no longer feel contempt for those who change themselves to be something else. So why don’t we all just dump the hypocrisy and leave Michael Jackson alone?

Even more importantly, now as black becomes the new white, with every top politician, actor or sportsperson being black, even Michael Jackson may have been tempted to get back his blackness. In fact in early 2008, Michael’s spokesman, Ed Hurlahee, disclosed on an MTV program, “These are hard times for Michael. He can’t help feeling like he made the wrong decision by undergoing the intensive whitening treatment all those years ago. Now that black people are really coming into their own, Michael has been left by the wayside and is fearful of being left behind.”

“Jackson spent millions with skin whitening treatments in the 1980’s and he does not have the cash to reverse the process. In fact, the process of trying to bring back Michael’s blackness may be detrimental to his health doctors and physicians have already disclosed to him. Michael is said to be very sad he is now a whitey and does not have any chance of coming back in the current black climate. Every celebrity and top person is now black. Michael is white. Now that’s a big problem for him and his backers,” a spokesman for Michael Jackson’s hard pressed PR company was quoted as saying, in late 2008.

So, while color lightening is a personal decision, it is important to be safe rather than be sorry. It is important to visit the right centers, get to the right specialists and make these choices after appropriate research. Even more importantly, one needs to understand that skin tone is not the only criteria for good looks or for good self-esteem– In fact a little tan might allow one to wear and look resplendent is many more colors. Moreover, one has to see skin whitening in its own perspective and not see it as a one-step-solution to all the ills in one’s life! Even more so, as who knows in the next decade or so, ‘brown’, ‘black’ and ‘yellow’ may become the new ‘white’ in the world pecking order!

You might think that it is really strange that a plastic surgeon is actually writing against cosmetic surgery and beauty products. I am not for or against cosmetic surgery but I am definitely against a consideration of cosmetic surgery and beauty products as a route to the end of all evils in your life! Stay Healthy.

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