All across the world, women of color aspire to have lighter and ‘brighter’ skin. African women want caramel skin, Asian women want olive skin, Arab women want a peaches and cream complexion, and Japanese women want alabaster white skin. Colorism is deeply ingrained among all races, and we believe a fairer complexion will lead to success in career and relationships.

But what price are you willing to pay for this universal obsession?

A middle aged woman with slate gray pigmentation on the temples and cheek bones.A 20 year old dusky girl with white lips after a session of ‘full face laser toning’. A 30 year old man with permanent white dotted spots all over his face after a ‘laser whitening’ treatment done in Korea. An 18 year old girl with stretch marks on her neck and chest from use of bleaching creams. A mother of two who developed facial hair from misuse of a medicated cream which gave her skin a lighter and translucent tone. A young man who can no longer step out in the sun without burning his skin in a matter of minutes. These are some of the alarming side effects of the ‘white beauty’ obsession that I have encountered in the past few years. And yet, fairness treatments are a billion dollar industry. In countries which have banned some of these creams, there is a mushrooming ‘under-the-counter’ black market where low grade toxic bleaching creams smuggled from third world countries are sold online. Some are sold at flea markets and local beauty salons; and many are touted to have “all natural ingredients” giving the user a sense of false security. In fact, most of these bleaching creams come in unmarked jars and tubes which do not contain an ingredient list. On the other, most women never go through the ingredient list at all as they are ill-informed about the potential side effects. Besides, in the fairness cream market, not all ingredients are disclosed! And they are everywhere- creams, gels, body lotions, face washes and soaps. While a lot is spoken about the sociological and anthropological aspects of colorism, not much is written about the side effects of fairness creams. This must change.

Bleaching creams often contain toxic and hazardous ingredients like mercury, corticosteroids, hydroquinone, arsenic or hydrogen peroxide. Mercury is poisonous and can damage the skin, brain, nerves, kidneys and bone marrow. Pregnant women who use mercury containing creams, can endanger the health of the unborn fetus. Mercury applied to the skin can be absorbed into the blood stream, and finally excreted through breast milk. This can expose your infant to mercury toxicity as well. The symptoms include memory loss, numbness of hands and feet, kidney failure, insomnia and psychiatric disorders. Even after you stop using the cream, the mercury can stay in your body for 1-2 months. India’s Shanaz Hussain Shabright Clear and Bright skin formula, and Pakistan’s Stillman’s skin bleach cream are 2 examples of mercury containing creams.

Steroid based fairness creams can also be extremely toxic when used for long periods of time. In fact, certain side effects can be noticed as early as a month. These creams can make your skin thinner so it bruises easily. You will notice the appearance of facial hair, acne, facial flushing and tiny red blood vessels on the skin. It can lead to stretch marks when used for full body lightening. Steroids get absorbed into your blood stream as well, and can cause weight gain, infertility, cataract, bone thinning and high blood pressure.

Hydroquinone is another notorious skin lightening agent which has been banned in UK, European Union, Japan, Canada, Australia and New Zealand. Hydroquinone can paradoxically lead to grayish pigmentation of the skin, which is permanent and hard to treat. This condition is known as exogenous ochronosis. Although it is uncommon, it is widely under-reported, unrecognized and misdiagnosed by dermatologists. And though this has never been demonstrated in humans, topical application of hydroquinone has proven to be a cancer-inducing drug in animal studies. Skin irritation, blotchy uneven skin lightening, and sun sensitivity are the relatively less dangerous side effects of this medication. Fade out cream and No Mark cream contain hydroquinone; along with over 80 commonly available fairness creams sold worldwide.

In fact, any fragranced cosmetic cream can create facial pigmentation when used regularly in the day time over a prolonged period of time. Dermatologists refer to this kind of pigmentation as Riehl’s melanosis. And in most Asian countries, fairness creams are the most commonly used daily cosmetic cream, as women get addicted to their skin lightening benefits. While certain fairness creams only contain vitamins which are harmless though ineffective, their counterfeit versions may contain toxic ingredients.

Dermatologists use a medication called ‘Triple formula’ or ‘Kligman’s regime’ to treat pigmentation disorders like melasma or facial melanosis. These creams contain hydroquinone, steroid and tretinoin in fixed concentrations. Patients are advised to use the medication on the affected area alone and for limited periods of time. However in my country, these creams can be purchased without a prescription, and are often misused. Triple formula is a medicated cream which is never meant to be used to bleach one’s natural skin color. I once met a lady who would use 25 tubes in a single week in an attempt to bleach her entire body. She ended up with disfiguring stretch marks all over her body in three months’ time.

So where should I go if I wish to lighten my skin? Surely a dermatologist should be able to use safe and effective creams and chemical peels to lighten my skin?

Please understand this- Your skin color is genetically determined and cannot be lightened with external applications. Only drugs like hydroquinone can lighten the skin by de-pigmenting it. However they were never meant for long term use on large areas of the body (including full face). The skin lightening effect is temporary and reversible, which makes one addicted and dependant on these potentially dangerous medications, in order to maintain the light look. Chemical peels are not tolerated well by dark skinned individuals. Women of color can only tolerate very superficial peels, which are not effective in skin lightening. Lasers can also cause permanent de-pigmentation and scarring in dark skinned individuals, especially at the hands of untrained or inexperienced practitioners. Some doctors are now resorting to extreme and dangerous therapies as they try to exploit this booming market. Glutathione is a powerful antioxidant which has some wonderful benefits for the liver. Taken orally, it gets completely digested and is fairly useless. It has been administered intravenously to cancer patients, to counter the harsh side effects of chemotherapy. This drug was found to lighten the skin and hair of patients as a side effect. Some doctors are now administering Glutathione by this route, solely for the purpose of skin lightening. This is a dangerous practice, and one risks kidney damage and fatal drug reactions, which are unacceptable side effects of a purely cosmetic treatment. Certain other treatments like injecting tranexamic acid into the skin, are not backed by medical evidence. Michael Jackson used the most dangerous of all skin lightening drugs- monobenzyl ether. He most likely suffered from a psychological illness called Body Dysmorphic Disorder.
So to put it bluntly, even dermatologists cannot lighten your natural skin tone in a safe and long lasting manner. Which is why, many responsible dermatologists are now refusing to entertain requests for skin lightening treatments. Dermatologists legitimately use skin lightening agents like low concentration hydroquinone to treat specific medical conditions, and even then, most of us are now leaning towards safer options like kojic acid, arbutin or azelaic acid, which are derived from Japanese rice wine, berries and rye/barley respectively, and proven to be safe for mid to long term use.

Skin lightening is an age old pursuit, be it Cleopatra bathing in goat’s milk or French women rubbing old wine to their face. But I see a disturbing trend, where mothers are using lightening creams on their young children, and seem to take great pride in doing so! While Caucasian women do great damage to their skin in tanning booths, women of color also take great risks in their pursuit of white perfection. It might be naïve on my end to assume that a few 1000 words can change mental attitudes and stereotypes ingrained over centuries. But in the very least, if I can make a few people reconsider their choices, then I would consider it a minor victory. If you have been using a skin lightening cream and have experienced any of the side effects mentioned in this article, please consult a physician without further delay