The practice of skin bleaching is widespread in the U.S. among individuals with darker complexions—especially women—yet users of these products are unaware of the dangers, according to a recent study published in the International Journal of Women’s Dermatology.
The researchers also discovered that colourism—valuing lighter-coloured skin as more attractive or desirable—is often a driving force behind these bleaching practices.
For the study, researchers distributed a confidential survey consisting of 19 questions to individuals with skin of colour residing in the United States. The survey encompassed inquiries related to participants' demographics, attitudes toward colourism, satisfaction with their skin tone, and habits regarding skin lightening. Out of the total 455 respondents who completed the survey, the breakdown by racial or ethnic background was as follows: 238 identified as Black, 83 as Asian, 84 as multiracial, 31 as Hispanic, 14 as American Indian or Alaskan Native, and five identified as other. A total of 80% were women.
Investigators found 21.3% of participants reported utilizing skin-brightening substances, and of these individuals, 75.3% employed them to address skin-related issues like acne, melasma, or hyperpigmentation. The remaining respondents employed the substances for overall skin-brightening purposes.
“The most striking discovery was the respondents' limited knowledge regarding the ingredients present in over-the-counter products and their potential harmful consequences,” noted Dr. Roopal Kundu, the lead researcher on the paper, in a press release. “These products are commonly acquired from local grocery stores, community-based shops, or even online platforms, and they do not undergo the same rigorous regulations as major retail chains or prescription-based items.”
Dr. Kundu is the founder and director of the Northwestern Medicine Center for Ethnic Skin and Hair and is a professor of dermatology at the Northwestern University Feinberg School of Medicine in Chicago.
The authors note that prior research has shown that these bleaching products are frequently contaminated with substances such as steroids and mercury, which can be detrimental to the skin and overall health.
While physicians may prescribe skin lighteners for specific skin conditions like melasma, these products can be used safely under the guidance of a medical professional. However, Dr. Kundu noted that most individuals who use skin lighteners do so without consulting a healthcare provider beforehand.
She mentioned that one of her patients had been using hydroquinone for lightening on his entire face for an extended period. As a result, the patient now has permanent hyperpigmentation.
According to the study, participants who used skin lighteners reported experiencing more pronounced colourism in their daily lives compared to those who did not use such products.
“There exists a perception that having lighter skin is regarded more positively within certain communities, such as Southeast Asian or African populations,” said Dr. Kundu. “This belief suggests that lighter skin is associated with increased attractiveness to potential partners or higher chances of securing employment. The notion is that lighter skin is intertwined with personal and professional achievements.”
Most of Dr. Kundu's patients seeking skin-lightening procedures are motivated by a desire to address uneven skin tone caused by a skin disease. However, approximately one-fourth of the study participants expressed a desire for overall skin lightening. Dr. Kundu shared an incident where one of her patients expressed his goal of completely lightening his skin. In response, she clarified that such a comprehensive alteration of skin colour was not feasible or within the scope of their treatments.
“As dermatologists, our aim is to comprehend the cultural and societal factors that influence skin health and the management of skin conditions,” said Dr. Kundu. “By being culturally aware, clinicians can better understand patients dealing with pigmentary concerns, enabling them to provide safe, effective, comprehensive, and empathetic dermatological treatments to individuals from all communities.”