Skin lightening obsession gone too far

Many people the world over, both men and women, use skin lightening creams for several reasons.

While some may use the creams as treatment for skin problems such as freckles, acne and chicken pox scars or as anti-ageing treatment, others use them on the entire body to bleach and look brighter because in some countries, lighter-coloured skin is a sign of a higher social status and enhanced beauty.

Recently, Ivory Coast banned skin-whitening creams due to health concerns.

There are, however, situations when lightening creams are recommended for medical use according to Dr Malik Ssempereza, a dermatologist at Unity Skin Clinic at Acacia Mall.

He explains, “When a person has had eczema, chicken pox, acne patches we can recommend a particular cream with specific ingredients but it must be used for a few weeks and under the supervision of the doctor. If someone has undergone fractional laser surgery; an anti-ageing procedure that may darken the area of the surgery as a side effect, the person may use lightening creams but the darkening effect of the surgery usually clears on its own after a few weeks.”

How skin lightening products work

Skin lightening procedures can take different forms according to Dr Malik Ssempereza, a dermatologist.

These forms include creams and lotions or injections and pills. These products contain chemicals that work by blocking the mechanism by which melanocytes make skin colour.

“Melanocytes are the cells responsible for making melanin, a pigment that gives skin and hair colour, expounds Dr Ssempereza, adding, “the more melanin the melanocytes produce, the darker the skin and the lesser melanin the brighter the skin colour.”

Absence or lessened melanin puts people using lightening creams at risk of skin cancer because melanin acts as a natural sunblock that protects the skin from the Ultra Violet rays of the sun and provides a sun protection factor (SPF).

The melanocytes produce melanin depending on the amount of sun present. This explains why people who live in areas where there is too much sunshine are usually dark-skinned.

The amount of melanin a person has depends on genetics but its production can be affected by injuries such as burns, exposure to sunlight, hormones and exposure to certain chemicals.

Toxic lightening ingredients

“There are so many lightening creams sold on the streets and buying any non-prescribed lightening creams could be the greatest regret of your life as many of them contain mercury, steroids, hydroquinone and parabens that may be carcinogenic,” says Dr Edward Ogwang, a dermatologist at Kampala Skin Clinic.

To make matters worse, these products are sold at low prices and unregulated in some countries which makes people prone to breast and skin cancers and other skin-related diseases.

Before buying and using any lightening products, make sure you read the instructions and ingredients and the amount contained therein.

Dr Malik Ssempereza recommends that the concentration of hydroquinone in the skin cream should not be more than two percent.

Hydroquinone causes ochronosis (binamakula), a serious and permanent form of damage of the deeper layers of the skin that cannot be treated or reversed. It also causes a burning sensation and if used for a long time, the ingredient can cause cancer. The use of mercury as an ingredient in whitening products has been banned in many countries because it is poisonous, cancerous and can cause kidney problems.

Steroids are supposed to be used as medication for a few weeks because they are known to cause stretch marks, make the skin very sensitive and prone to infections, allergies. They wash off the skin and make it thin out that the veins are easily seen. Barbara Kamusiime, the public relations officer of Uganda National Bureau of Standards says, “We do not accept any creams containing mercury, hydroquinone and steroids in Uganda. We only accept one or two per cent content of hydroquinone in the hair products only.”

Kamusiime adds that the products that contain any of the banned ingredients are sometimes smuggled and sold in the country cheaply but there are market surveillance officers who make sure these products do not reach people because they are very dangerous to people’s health. The countries where mercury and hydroquinone products have been banned include; Tanzania, Ivory Coast, Kenya, United Kingdom, Zambia, South Africa, Australia, Japan, Malaysia,Thailand and parts of European Union including Switzerland and England.

Effects of skin bleaching

•Prolonged use of skin bleaching products can contribute to premature aging of skin.

• Long-term use may increase the risk of skin cancer from sun exposure. Always use sunscreen when using a skin lightener and going out in the sun.

• Steroids in some skin lighteners may increase risk of skin infections, skin thinning, acne, and slow healing of wounds.

Get lighter skin safely

Lightening creams are not recommended in dermatology according to Dr Henry Ngobi, a skin specialist at Jinja Hospital. People should learn to appreciate who they are because the creams are not safe at all.

“People should never worry about the colour of their skin because the skin tone where the body is covered, is their real colour. All they need to do is avoid staying out too long in the sun and within a few months, they will achieve the right skin texture,” says Dr Malik Ssempereza.

One can try to achieve skin evenness by staying indoors and keeping the body covered to protect it from sunburns.

Sun screen with a sun protection factor (SPF)of 30 is recommended. Kojic acid and lemon line can help penetrate into the skin to clear some skin problems that may have caused darkening and spotting of the skin.

“The skin lightening injection containing glutathione supplement is a safe product although it is commonly used as treatment for people with liver problems to detoxify the liver. One can also use chemical peels to improve facial skin texture. It involves using a chemical solution that causes the old skin to soften and peel off and the regenerated skin is usually smooth and less wrinkled,” says Dr Ssempereza.

Precautions to take

Talk to your dermatologist before using a particular skin lightening cream and ask for instructions on how and when to use the product.

•Make sure that the product contains no mercury. The ingredient mercury is sometimes listed as calomel, mercurio, mercuric or mercurous.

•If a label of a lightening cream lists hydroquinone as part of the ingredients but does not mention how much of it is contained in the product, do not assume that it is safe for use. Some products contain more hydroquinone than is allowed while some labels may not be accurate. See a dermatologist for any queries.

How I brightened my skin naturally

“Having a beautiful skin has always been my dream since campus time, meaning a single pimple on my face could make tears roll down my cheeks. Sometimes they could manifest as a sign of my periods, leaving after spots which worsened the look. Can you imagine how a cute the face looked with those ugly black spots? Terrible! Instead, my sister made fun of me, because to her, I resembled a leopard.

However, today it is a different story. My face is as smooth as a baby’s. This was after I talked to a skin specialist and beauty consultant Julie Katelemwa who examined my skin and advised me on the best way to regain it.

This included eating well, including more fruits, cleansing it, drinking warm water and using the right creams, lotions plus soap.

The specialist showed me the need to know my skin type before applying anything on it. In her view, using homemade facials and scrubs such as milk, and sugar are good because they cost less, yet are very effective.

Food items such as honey, eggs, milk, turmeric, onions, water, tea leaves and fruits such as avocado, paw paw, watermelon, bananas and lemons can be added to homemade masks. Avocados and lemons are rich in vitamin C which acts as an antioxidant that helps to protect the skin from ageing.

Sometimes I apply avocados on my face which helps me attain the nourishment. When using avocado, I mix it with honey and -apply it for about 20 to 30 minutes at night.

I always make sure that I eat bananas, watermelon, lemons or avocado and five glasses of warm water daily. I also keep face and hand cream in my hand bag.

Once a day, usually after lunch, I wash my face and re-apply the lotion. This is to remove the dust that clogs my face on my way to work. This also helps me to keep fresh.

Keeping out of the hot sun is another thing I take note of to prevent my skin from developing wrinkles and ageing.

And since my facial area is delicate, I don’t use a sponge or even a towel on it and I don’t scrub it the way I do the rest of my body. I normally wash it with medicated bathing soap at least five times till it turns oil free.

However, I make my cleanser from tea leaves, ginger, garlic and honey after boiling and after filtering them, I mix it with honey as told by the expert. This helps to remove dirt and oil from the skin. I do not use harsh soaps because they might burn my skin.”