Not a fair deal

Skin lightening creams reveal their dark side as both men and women face the not so ‘pretty’ after-effects

Just five months before her marriage, Nisha Singh, a 22-year-old professional, was diagnosed with mild melasma, a tan or dark facial skin discolouration. Her dermatologist recommended a cream-based formulation to be applied twice a day on the chin alone. But in a hurry to get a glow on her face, Nisha ended up using it seven times-a-day. The result? Whiteness of a different kind. She was diagnosed with leucoderma, an acquired depigmentation.

Nisha’s was an extreme case but others in the past have committed similar blunders.While she made use of a prescribed clinical formula, one wonders what would be the fate of those who use popular, celebrity-endorsed fairness creams and soaps without consultation?

It’s not all foul play, assures Dr Ahmed Zaheer, head of dermatology, Max Healthcare, Delhi. “Hydroquinone (HQ)” he says, “is the key component in most whitening pharmaceutical creams, which lightens the complexion by reducing melanin formation.” He adds, “It is safe as long as its concentration does not exceed five per cent and is not used beyond four months, after which it can cause photosensitivity (allergy of facial skin to the sun) and in rare cases, ochronosis—a condition chara-cterised by grey-brown or blue-black hyperpigmentation and caviar-like papules.” HQ-based creams are readily available in the Indian market, but should only be taken on doctor’s prescription.

Story continues below this ad

Pharmacies are, however, known to sell fairness skin creams over the counter. Dermatologist Dr Rishi Kumar Parashar of Sir Ganga Ram Hospital, Delhi, says, “Over the years, local pharmacists have realised that these creams are prescribed to dark-complexioned people. So, now, they sell it to anybody who asks for gorepan ki cream.”

An international daily, recently reported the case of a 28-year-old coloured UK resident who used a steroid formulation, clobetasol for seven years. The formulation did not lighten her skin colour, instead she gained weight, had stretch marks on her body, bruised skin, hair growth on her face and could not conceive.
“The skin-lightening creams are usually high on steroids. Not all steroids like monetasane, fluticasone and hydrocortisone are harmful and can be used under medical supervision. But there are others, which can harm your system,” says Dr Parashar. Endocrinologists say that externally given steroids, which are synthetic hormones, can suppress the production of natural hormones. “The production of a natural steroid such as estrogen that maintains the skin’s vitality can get affected if an external steroid is given. This, in turn, can lead to development of facial hair, thinning of skin and can affect fertility,” says Dr Neeru Gera, endocrinologist.

So why are these hormone laden products still sought after? Should fairness creams come with a statutory warning? Dr Zaheer explains, “It’s not obligatory for the cosmetic industry to disclose all contents so one can expect very little or no transparency.”

Despite the obsession, the fact remains fairness is just not in our genes. Genetically, there are five skin types, numbered from 1 to 5. Most Indians have Type 3, 4 or 5 skin, which generally tans and seldom burns. Typically, Kashmiris would have Type 3 skin and Dravidians would have Type 5. The rest—that’s roughly 80 per cent of the populace—would be Type 4. “Our type of skin is right for us, given our climatic conditions,” says Dr Parashar.
Yet to fulfil the Indian obsession with fairness, dermatologists recommend a sunscreen with an SPF 15.