Most people have an unspoken feeling that gravitates towards having a fairer complexion. The journey in search of the products, which claims to offer fairer tone, is widely expanding. It is expanded in such a pace, that people are often swept away by the marketing gimmicks. Various pharmaceutical companies and cosmetic corporations endorse skin-lightening products through print media , internet and television. Thus, customers often compromise on the logical understanding of the products: how exactly it works? what could be the possible results or side effects (if any)? are the results long lasting?
An increasing impetus to have a fairer skin tone, often results in a paradoxical effect- Cosmetic Melanosis. This is a condition, where the skin gets more darkened than before due to injudicious use of bleaching creams and over-the-counter (OTC) skin glow products. This article elucidates about Cosmetic Melanosis and the ways to prevent the same.
Hydroquinone (Hq) is the most common depigmenting agent available in the market. It gives a drastic colour change over a short period. However, the FDA and other standard setting agencies have reported that, long term use of Hq can result in blue-black darkening and thickening of skin, a condition called Ochronosis. A study was conducted, amongst darker skin individuals from two South African hospitals. Among 69% of patients who used skin-lightening agents, 42% of females and 15% of males were recognised with Ochronosis. Hq also makes skin sensitive to sunlight. Hence, it is mandatory to use good sun-safety measures when using Hq containing products. Nevertheless, most patients who buy OTC products are not aware of the importance of sun protection. Thus, they notice skin darkening in spite of using this agent continuously.
In fact, Hq is banned in certain parts of the world due to its long-term side effects. In India, 2% Hq is available over the counter and 4% available from doctor’s prescription. However, it is not advisable to use Hq more than 3 months due to its side effects. Though, the National toxicology programme, which provides scientific study data to FDA in U.S is still assessing the long-term dermal toxicity effects of Hq, there are few animal studies, indicating that oral Hq has carcinogenicity and immunotoxic properties.
In addition to Hq, the other common ingredients in skin glow products are steroids and tretinoin ( Vitamin A derivative). Tretinoin helps in penetration of Hq, whilst steroid helps in reducing the irritation caused by tretnoin and Hq. This combination is studied worldwide and is proven effective in skin lightening. However, if used over a wide-time frame, steroids can result in side effects such as acne, hirsutism and telengectesia (fine blood vessels under skin) and skin atrophy. Similarly, imprudent use of tretinoin, can result in retinoid dermatitis, where there is intense irritation, dryness and redness of the skin. Using Hq and tretnoin continuously in areas with thin skin such as nasolabial folds and around eyes, can result in hyperchromia (skin darkening). Thus, it is worth an effort to have these products prescribed by a skin specialist who would advice rightly on how to apply these products and for how long to apply.
Another common way of masking skin pigmentation is through use of bleaching agents. In many areas, unregulated products are sold without listing their contents. These agents often contain steroids, Hq and mercury oxide. In most bleaching products, Hq may be included with different names such as Quinol, Benzene-1, 4-Diol, Tequinol and many more. Thus, the customers are not aware of the exact product contents. Mercury can cause skin and nail darkening gradually. In a study conducted in 620 females from Saudi Arabia, most females were forced to use the bleaching agents, as stopping them caused more darkening of the skin. Thus, they were compelled to carry on the practice of using bleaching agents.
It is always worth an effort to understand the reasons behind pigmentation, before commencing any treatment with the skin glow products. The reasons can vary from simple sun damage to inflammatory skin disorders. Doctor’s palette of skin brightening treatment options are widely increasing ranging from topical agents to physical treatment options such as chemical peeling and lasers. A formal assessment with the skin specialist will help with:
-Understanding of the pigmentary problem in depth
-Understanding different treatment options
-Choosing the option according to your concern and skin type
-Understanding how the treatment works
-Precautions while switching treatment options
– Understanding the side effects and how to get it treated, if any
Thus, the treatment through a skin specialist will be individualised according to patient’s skin characteristic and cosmetic concerns unlike OTC products, to prevent adverse effects such as Cosmetic Melanosis.