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If you want to lighten or even out your skin color, there are effective skin bleaching products and procedures on the market—but some pose very real risks to your health. How does skin bleaching work, and what are the best and worst ways to do it? Keep reading to find out.
What is skin bleaching?
Skin bleaching, also called skin lightening, skin whitening, and skin brightening, uses synthetic or natural products to lighten or even out skin color. Sales of skin whitening agents increase annually, led by the Asian market. Particularly in India, China, and Korea, skin color is an important factor in social status: People with fair skin, especially women, may be more likely to be viewed by some as young, beautiful, or of a high social class (Schroff, 2018; Qian, 2020). Because of this, the market for skin bleaching agents is huge. It’s been estimated that 15% of the world’s population uses skin whitening products (Pillaiyar, 2017).
Unfortunately, many of those products are dangerous and pose real health risks.
How does skin bleaching work?
Skin bleaching works by reducing the skin’s concentration of melanin (pigment). People with darker skin have more melanin in their skin than people with lighter skin. Skin cells called melanocytes produce melanin (Desmedt, 2016).
Skin bleaching products aren’t regulated by the FDA. Traditional lightening agents contain chemicals such as corticosteroids, hydroquinone, and mercury. They lighten skin tone either by blocking the growth of melanocytes or by interfering with melanin production. However, in the process, these products damage the melanocytes. They may also be absorbed into the bloodstream and circulate throughout the body, affecting areas besides the skin. Some of these side effects can be very serious, including dermatitis, irritation, sensitivity, toxicity, kidney damage, and brain damage (Qian, 2020).
Because of these harmful side effects, the cosmetic industry is now taking a different approach to skin lightening. Some of the newer, alternative lightening products are derived from plants. They typically work by suppressing the activity of tyrosinase, a naturally occurring enzyme that helps to make melanin. Alternative products may contain plant-derived agents such as arbutin, which comes from the bearberry plant, and its derivatives kojic acid and nicotinamide. While these products may still cause local irritation and sensitivity, they are thought to be less risky than traditional products like mercury compounds (Qian, 2020).
What are skin bleaching creams?
Common topical (applied to the skin) bleaching creams and lotions have historically contained hydroquinone, corticosteroids, and mercury compounds. Although they’re generally effective, these chemicals can have serious side effects, both on the skin area they’re applied to and throughout the body (Qian, 2020):
- Steroids (corticosteroids), when used over large areas for long periods, can have side effects such as acne, infection, inflammation, osteoporosis, a condition called Cushing’s syndrome, and more.
- Mercury compounds can cause mercury poisoning and damage the nervous system. Side effects include headache, hearing loss, disordered thoughts, kidney damage, and even death. Skin bleaching products containing mercury are banned in the United States, but products made overseas may still contain mercury.
- Hydroquinone has long been the mainstay of skin lightening. It’s available as a 2% concentration over the counter or 4% by prescription. If used for long periods, it can cause blue-black skin discoloration called ochronosis (Schwartz, 2021). Hydroquinone is banned in the European Union but can be sold in the United States.
Skin, the body’s largest organ: layers, functions, and conditions
Other agents found in skin lightening creams
Since traditional lightening agents come with some serious potential side effects, you may see other ingredients used instead.
- Tretinoin (retinoic acid) is commonly used for its anti-aging effects on the skin and for acne, but it also helps lighten skin. Pregnant women shouldn’t use it because it may cause harm to the fetus (Desmedt, 2016).
- Glutathione is an antioxidant and is used in cancer treatment. It’s a popular skin lightener in some countries, but its safety and effectiveness of glutathione haven’t been evaluated enough to formally recommend its use as a lightener (Sonthalia, 2016).
Newer alternatives that may have fewer or less serious side effects include:
- Alpha hydroxy acid (AHA)
- Niacin (B3) and niacinamide
- Arbutin and its derivatives kojic acid and nicotinamide
- Vitamin C
- Vitamin E
- Licorice extract
- Azelaic acid
- N-acetyl glucosamine
At-home skin lightening ingredients
Some of the following are commonly recommended for homemade skin lightening products, but their effectiveness may be mixed:
- Lemon juice and water
- Olive oil and honey
- Aloe vera gel
- Turmeric (mixed with yogurt)
What are oral skin bleaching products?
There are a number of products that can be taken orally (by mouth) to lighten skin. These are newer treatments. Although they currently appear to be effective and safe, more research is needed to determine if they’re safe for all people or when taken for longer periods. If you’re interested in oral skin lightening products, talk to your healthcare provider about your best options. Some oral products include (Juhasz, 2018; Grimes, 2018):
- Glutathione (GSH)
- Polypodium leucotomos hydrophilic extract
- Tranexamic acid
Glutathione is sometimes used intravenously (injected) for skin lightening. This increases the risk of dangerous side effects and should be avoided.
Hyperpigmentation: what is it, causes, and how to get rid of it
What are skin bleaching procedures?
Laser treatment can be used to lighten areas of dark skin and to do overall skin bleaching. While laser treatment can be effective, it can take as many as a dozen treatments to complete and can be quite expensive. People with sensitive skin or skin that tends to scar may not be good candidates for laser treatment.
What’s the best way to do skin bleaching?
Skin bleaching is best used to lighten specific dark spots or small areas of discolored skin. Skin lightening agents can help with:
- Pigmentation left from acne blemishes
- Age spots
- Spots and melasma (darkened areas due to sun exposure)
Using skin lightening agents on small areas of skin discoloration rather than on a large scale reduces the risk of serious side effects.
Should you do skin bleaching?
Using skin bleaching agents over large areas of skin can cause premature aging of the skin by making the skin more fragile. Having fragile, damaged skin also increases your risk of skin cancer. Always use a high-SPF sunscreen if you’re using skin-lightening products.
Pregnant women should consult with their healthcare provider before using any skin lightening agent.
If you’d like to try skin bleaching of any kind, stay safe and start by talking to a dermatologist. Products bought online, and even DIY at-home products, may run the risk of negative effects, even if used as directed. Skin lightening is one situation when it’s best to follow the guidance of a medical professional.
- Desmedt, B., Courselle, P., De Beer, J. O., Rogiers, V., Grosber, M., Deconinck, E., & De Paepe, K. (2016). Overview of skin whitening agents with an insight into the illegal cosmetic market in Europe. Journal of the European Academy of Dermatology and Venereology : JEADV, 30(6), 943–950. doi: 10.1111/jdv.13595. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26953335/
- Grimes, P. E., Ijaz, S., Nashawati, R., & Kwak, D. (2018). New oral and topical approaches for the treatment of melasma. International Journal of Women’s Dermatology, 5(1), 30–36. doi: 10.1016/j.ijwd.2018.09.004. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374710/
- Juhasz, M., & Levin, M. K. (2018). The role of systemic treatments for skin lightening. Journal of Cosmetic Dermatology, 17(6), 1144–1157. doi: 10.1111/jocd.12747. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30133125/
- Pillaiyar, T., Manickam, M., & Namasivayam, V. (2017). Skin whitening agents: medicinal chemistry perspective of tyrosinase inhibitors. Journal of Enzyme Inhibition and Medicinal Chemistry, 32(1), 403–425. doi: 10.1080/14756366.2016.1256882. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010116/
- Qian, W., Liu, W., Zhu, D., Cao, Y., Tang, A., Gong, G., & Su, H. (2020). Natural skin-whitening compounds for the treatment of melanogenesis (Review). Experimental and Therapeutic Medicine, 20(1), 173–185. doi: 10.3892/etm.2020.8687. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271691/
- Schwartz, C., Jan, A., & Zito, P. M. (2021). Hydroquinone. [Updated May 10, 2021]. In: StatPearls [Internet]. Retrieved on Oct. 4, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK539693/
- Shroff, H., Diedrichs, P. C., & Craddock, N. (2018). Skin color, cultural capital, and beauty products: an investigation of the use of skin fairness products in Mumbai, India. Frontiers in Public Health, 5, 365. doi: 10.3389/fpubh.2017.00365. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787082/
- Sonthalia, S., Daulatabad, D., & Sarkar, R. (2016). Glutathione as a skin whitening agent: Facts, myths, evidence and controversies. Indian Journal of Dermatology, Venereology and Leprology, 82(3), 262–272. doi: 10.4103/0378-6323.179088. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27088927/
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.