SKin BLeachinG...

by MoJi allen

Skin bleaching has become a rather common activity especially in Nigeria that one would have to think twice before starting on a program that will lessen the tone of the skin. Style consulted dr Hilda Titiloye, the Clinic director at Skin101 Clinics, Abuja speaks on the possible benefits and risks involved in skin bleaching. Skin101 is a Cosmetic Medical Clinic providing dermatology, Aesthetic and Anti-aging Medical services. Here’s what she had to say...

Skin lightening has been in existence from time immemorial. from Cleopatra in the 1st century BC bathing in sour donkeymilk to Queen Elizabeth I in the 1600s who desired porcelain white skin so much that her long use of lead containing Ceruse eventually led to her demise. The desire for lighter skin as a sign of class and wealth has trickled down many generations to now deeply impact the darker coloured races making skin lightening/bleaching/ whitening/brightening almost an epidemic.

To start with, let’s define the terminologies under which this disturbing skin altering trend is disguised. Skin lightening is simply the process of making one’s skin lighter, be it by one shade or several shades, the popular notion is that when people lighten they do so to return to their original complexion following long periods of exposure to the sun or other external factors. Skin brightening is a way of imparting a natural vivid radiance to skin by improving the skin’s natural ability to shed dead cells through exfoliation therefore leaving the skin with a brighter hue, hardly more than a shade to two shades lighter. Skin bleaching is the reduction of the production of melanin and this can result in skin getting many shades lighter. Skin whitening is aimed as stripping the skin of pigment.

Without doubt, lighter skin is deemed by many to be much more attractive thereby more desirable. Skin bleaching can very well help achieve this more attractive, lighter skin, but it is not without consequences.

Talking about bleaching products; back in the day, the hot movates, temprovate etc were the go-to bleaching products. With increased awareness about the dangers of these steroids, those were slowly being boycotted. What is now happening is that these same highly potent steroids have been repackaged and are mostly sold as herbal mixed creams, triple action creams amongst others, with claims of being 100% safe with no side effects. The users now know these claims are untrue. Other caustic products, mercury are still being used but repackaged in more acceptable and appealing forms, all with the same promise of safety. Hydroquinone has been painted to be very bad, but the problem is not with hydroquinone but with the way it is used. Hydroquinone remains the gold standard for the treatment of Hyperpigmented lesions, with recent studies recommending that it should not be used beyond six months at a time. We have people using hydroquinone based products for more than 10 years, of course it will give problems.

At our practice, most of the cosmetic medical cases we see are side effects of bleaching products. from profuse stretch marks, to steroid acne(pimples), irritant dermatitis, sun burn, thin skin, exogenous ochronosis, premature aging, discolored nails and eyes…just name them. let’s not forget the theoretical increased risk of developing skin cancers seeing as there is less protection from sun damage following the suppression of melanin production. Then there is the risk of blood borne infections, deadly air embolism, thyroid disorders, kidney stones etc that accompany the latest whitening trend with intravenous glutathione, a great anti-oxidant that has been greatly abused for skin whitening purposes.

Now, what is the way forward? We see patients with the legitimate need to lighten skin either from post inflammatory hyperpigmentation or darkening following chronic sun exposure. In these cases, we do prescribe bleaching products which we monitor closely and control. Once the problem is fixed, we cease use. If we recommend anything at all for the long term, it is skin brightening as it keeps skin blemish free, radiant and glowing without the long-term side effects of other bleaching products. We maximize the use of exfoliants mainly alpha and beta hydroxy acids like lactic acid (from milk) glycolic acid (from sugarcane), mandelic acid (from almonds)etc., we love vitamin C too! These are found in many daily use skincare products. These ingredients will not only help keep your skin blemish free, they also stimulate the production of collagen therefore keeping your skin young and wrinkle free for a long long time. We can never emphasize enough the importance of using sun protection, minimum SPf30, even in the darkest of skins. The sun is the number one cause of extrinsic aging, in as much as we wrinkle later than our whiteskinned counterparts, to keep our skin even-coloured as we get older, we MuST use sun protection.

Apart from the side effects that accompany long term use of bleaching products, the natural progression is after using a particular bleaching product for some time, no matter how fantastic, it eventually stops working. The user realizes that they have to keep moving up the ladder of bleaching products, increasingly needing stronger products, eventually getting to a place where nothing works. When they get to this place, there is a rebound hyperpigmentation that even results in them getting darker than their original complexion. The truth about skin bleaching is that it will be a life long struggle to keep up which one can never win. Remember the skin we have is meant to serve us for the rest of our lives. You can have a heart transplant, a lung transplant, liver transplant...but a skin transplant? Highly unlikely. If you destroy the skin you were born with, you will have to live with it for the rest of your life.

Now the ultimate question is...To bleach or not to bleach?