Just the other day I met a young man who presented at a dermatology clinic. On examination the intriguing thing I found was that he was dark in complexion but his skin was dark between his digits.
Bleaching has become a problem in our society more commonly among our women. The WHO estimates that 77% of Nigerian women bleach their skin with a lesser percentage found in other African countries.
Reasons for bleaching
Bleaching is for medical reasons e.g vitiligo, acne, melasma, hypo/hyperpigmented scars following burns, but women usually bleach for the sake of cosmesis as they perceive light-skinned women as more beautiful.
Bleaching is favourably done either with chemicals (creams, ointments, lotions) or bleaching surgery. Skin lightning or bleaching surgery is not very common in our environment but the use of chemicals is all too common.
The only FDA approved bleaching agent is hydroquinone and is found in varying concentrations in most bleaching creams. Hydroquinone works by decreasing the production and increasing the breakdown of melanosomes (melanin pigment granules) in the skin’s pigment cells (melanocytes). It does this by inhibiting the activity of tyrosinase, the enzyme needed to make melanin. Melanin is the pigment that gives our skin and the iris its color.
Another alternative is heavy metals like mercury. Mercury is a common ingredient found in skin lightening soaps and creams. It is also found in other cosmetics, such as eye makeup cleansing products and mascara. Skin lightening soaps and creams are commonly used in African and Asian nations. They are also used among dark-skinned populations in Europe and North America. Mercury salts inhibit formation of melanin, resulting in a lighter skin tone. Mercury in cosmetics exists in two forms: inorganic and organic. Inorganic mercury (e.g. ammoniated mercury); also used in skin lightening soaps and creams. Organic mercury compounds are found in eye makeup cleansing products and mascara.
Hydroquinone cream is very well tolerated. Some women may experience minor and temporary skin irritations including mild itching or stinging and reddening of the skin (irritant contact dermatitis). severe burning, itching, crusting, or swelling of treated areas (possible allergic contact dermatitis) and any unusual skin discolorations usually warrants discontinuation of the cream. Prolonged use of hydroquinone associates with development of exogenous ochronosis (a persistent blue-black pigmentation), especially in Africans, but this is rare.
Side effects of mercury over the long-term
This includes, graying of the skin, allergic reactions (may also happen acutely), systemic mercury poisoning: kidney damage, neurologic symptoms (tremors, memory problems, generalized pains, vertigo, lassitude), and pregnancy loss or fetal malformation.
On the short-term the benefits of skin bleaching creams may seem to outweigh the risk but on the long-term it just isn’t worth it.
If you feel the overwhelming need to see your skin lighten:
1) Make sure you’re not pregnant
2) make sure you’re not breast-feeding
3) See your dermatologist (bleaching creams are like any medication don’t self-medicate).
4) If you react to the cream, stop it immediately.