‘TO be more beautiful every day’. That’s the guarantee the makers of one skin-whitening cream have plastered on its label. A picture of a smiling woman graces the aluminium bottle; her facial features and hairstyle appear to be that of an African woman but her skin is pale white.
Skin-whitening creams are used by many who associate lighter skin with beauty and social acceptance among other things but there is enough evidence that proves such products are not safe and can lead to hospitalisation or worse.
The popularity of skin-lightening products in our society is of great concern, says consultant dermatologist Dr Aleah Ali who works at the South West Regional Health Authority and the Advanced Dermatology and Skin Care Centre.
“In my practice at both the public hospitals and private clinics, I have seen disfiguring and dangerous complications associated with unregulated skin bleaching. Most patients are unaware of complications associated with skin bleaching creams available over-the-counter,” she says.
A study that was published in The Journal of Public Health Research in 2017 revealed startling results of tests that were done on 15 over-the-counter skin-whitening creams sold in pharmacies and cosmetic retailers in T&T. The research study titled ‘The evaluation of total Mercury and Arsenic in skin-bleaching creams commonly used in Trinidad and Tobago and their potential risk to the people of the Caribbean’ concluded that “all samples contained significant amounts of mercury and arsenic and none can be considered safe for prolonged use.”
The authors of The UWI-sponsored study found that “the popularity of these creams in the Caribbean region places the population at elevated risk of chronic mercury and arsenic poisoning and possibly acute mercury poisoning”.
Additionally, some creams available on the market include unlisted ingredients and international studies have proven that the most used ingredient is clobetsol propionate — a potent topical steroid cream, says Ali.
In 2006, years before the above mentioned study was done, the Food and Drug Administration (FDA) issued a notice that over-the-counter skin-bleaching products are not recognised as safe and effective. The products were deemed not safe for human use based on a review of evidence.
What are some of the effects of skin-bleaching products? The consultant dermatologist explains.
“When skin-bleaching creams are used for long durations on large areas and under hot humid conditions, percutaneous skin absorption is enhanced. This increases complications. Some of these complications are steroid induced acne, impaired healing, ochronosis, mercury poisoning (particularly dangerous in pregnant women and infants), nephropathy (kidney disease), skin infections and hormonal issues,” she says.
The UK-trained dermatologist has also seen the side effects caused by skin-bleaching creams which contain corticosteroid; a few years ago she attended to a young female who developed facial skin sepsis and severe steroid induced acne which required hospital admission.
“I have seen patients who have developed exogenous ochronosis from prolonged unregulated Hydroquinone use. This presents as a blue-black pigmentation which is notoriously difficult to treat. I have had a few patients with scarring (burnt skin) from blue soap and patients with extensive stretch marks,” she says.
Health problems associated with skin bleaching are also prominent in neighbouring Caribbean islands. Ali referred to a study of fisherfolk in Barbados which found higher levels of mercury in women who used bleaching creams than from regular consumption of fish.
Contrary to popular opinion women aren’t the only users of bleaching creams and soaps. Reggae dancehall artiste Vybz Kartel who defended his use of bleaching products has not only promoted the use of ‘cake soap’ in his music but also released his own line of skin-brightening creams. To curb the trend of skin bleaching, Jamaican health authorities embarked on an initiative ‘Don’t Kill the Skin’.
Ali’s advice to people who may be curious about skin-whitening products? Celebrate your melanin.
“I truly believe that melanin is something we should celebrate and be proud of. Melanin is our body’s natural defence that protects us from the sun’s harmful UVA and UVB rays,” she says.
The dermatologist referred to the Fitzpatrick scale which highlights six skin types and their reaction to UV exposure. Most people in Trinidad are between four and six (medium brown to dark skin) on the scale which means their skin ages at a slower rate than those between one and three on the scale. They are also less likely to get skin cancer. However if someone bleaches their skin by any means, then they are stripping their skin of its natural protection against the sun.
Although treating skin issues like hyperpigmentation does come at a cost, the side effects of unregulated use of skin-bleaching products that are not FDA approved can be even costlier.
“Skin bleaching is a personal choice that should not be made lightly and has been linked with adverse side effects,” warns Ali. “It is in the patient’s best interest to seek professional advice for safer alternatives before undertaking such a practice.”