With the global market for skin lighteners continuing to rise, dermatologists from the American Academy of Dermatology (AAD) are expressing concern over the growing trend and the unintended health consequences for patients who use these skin lightener products.
According to the AAD, the global market for skin lighteners was estimated at US$8.6 billion in 2020 with the market projected to reach $12.3 billion by 2027.
Dr. Seemal R. Desai, a clinical assistant professor of dermatology at the University of Texas Southwestern Medical Center, discussed the rise in skin bleaching and the risks to patient's health at the AAD Virtual Meeting Experience (April 23-25, 2021).
“The cultural beliefs that promote the practice of skin bleaching date back centuries and deeply affect many of our patients with skin of colour,” said Dr. Desai, who has a private practice dedicated to treating patients with skin of colour, in a press release. “It is going to take time to change these deeply-rooted cultural values and psychological associations with lighter skin tones; however, we want to educate patients about the dangers of skin bleaching strictly for the sake of achieving lighter skin and encourage them to talk with their dermatologist so that we can begin changing this dialogue.”
The AAD notes patients can use bleaching creams safely at the recommendation of a dermatologist to treat pigmentary conditions such as melasma. However, dermatologists are concerned about patients using these products to change the colour of their complexion.
Dermatologists are especially worried about skin bleaching products that are not regulated by the U.S. FDA and are sold online from other countries. The unregulated products could contain dangerously high concentrations of hydroquinone and topical steroids, they note.
Dr. Desai warned that unregulated products can have negative consequences for patients that use them. He added patients can experience skin rashes, steroid-induced acne and subsequent scarring, as well as thinning skin and skin ulcers as a result of using skin bleaching products purchased from unknown sources online.
“The bottom line is that skin bleaching products that [patients] are purchasing online and overseas may not be safe,” said Dr. Desai. “In some cases, ingredients are not listed on the package, which should be a big warning sign to stay away. Although rare, there have been reports of mercury and arsenic in skin bleaching products.”
Dr. Desai said in some cases patients using skin bleaching products can develop exogenous ochronosis after long-term use of bleaching creams that contain hydroquinone.
“Many people with skin of colour will go to great lengths and incur great costs to change their skin tone,” Dr. Desai explained. “It is time to stop the spread of poisonous information that perpetuates beliefs that lighter skin equals more beautiful skin whether it’s through product marketing or social media, and begin to empower consumers to feel beautiful and comfortable in their own natural skin colour.”
For patients with pigmentary conditions such as melasma and post-inflammatory hyperpigmentation that create uneven skin tones, Dr. Desai recommends they consult a dermatologist who is trained to treat these conditions safely and effectively.