Nearly every skincare brand in the world has some kind of fairness or skin lightening cream or serum in tis range. Particularly here in the Gulf, there is a surge of these creams which many women hope will lighten their skin tones. HEALTH meets with Dermatologist Dr. Nirmala Markandeya at GMC Hospital in Ajman to find out more about this controversial topic.

Ideal Beauty Perceptions

According to Dr. Markandeya, arguably, light skin has become an aesthetic ideal; it being perceived as attractive and an asset of the rich. “Matrimonial advertisements for fairer brides prove that the obsession for fairer skin prevails among the dark and brown skinned ones,” she says and though it is hard to argue on a cultural level, lighter skin has always been perceived as ‘more’ beautiful and is often related with truthfulness, innocence, purity and goodness.

Potential Poison

Skin lightening products, tells Dr. Markandeya, contain a variety of substances the consumers are unaware of. “Bleaching products suspected to contain harmful active substances may provoke local as well as systemic toxic effects,” she says with the whitening agents mostly detected are hydroquinone, tretinoin, corticosteroids and mercury salts. Prolonged use of these drugs poses a serious health risk and indeed may trigger irreversible skin problems such as patchy hyper- or hypopigmentation, skin atrophy, stretch marks, delayed wound healing and may reactivate skin infections. In extreme cases, there have been cases of skin cancer attributed to kinlightening cosmetics. However, Dr. Markandeya stresses that broad spectrum sunscreens are the cornerstone of hyperpigmentation therapy.

Safer Alternatives

Plant extracts, points out Dr.Markandeya, are potentially safe and effective skin lightening agents. She highlights other safe alternatives as follows:

• Curcumin has been reported to suppress melanin pigment formation.
• Vitamin C is a naturally occurring antioxidant which acts at various oxidative steps of melanin formation, thus inhibiting its formation.
• Arbutin is a naturally occurring plant derived compound found in the dried leaves of a number of different plant species including, bearberry, blueberry,cranberry, and pear trees.
• Kojic acid is a naturally occurring fungal derivative reduces hyperpigmentation by inhibiting melanin production.
• Alpha tocopherol (Vitamin E) is a major antioxidant in the body. Like other naturally occurring derivatives, it inhibits melanin formation.
• Niacinamide is the physiologically active form of vitamin B3. It interferes with the interaction between skin cells and melanin forming cells, thereby inhibiting melanin production. Regular use of niacinamide with sunscreen is effective in reducing hyperpigmentation.
• Others include grape seed extract, orchid extract, aloe vera extract, pycnogenol, marine algae extract, cinnamic acid, flavonoids, green tea extracts, aloesin, coffeeberry, Mulberry extract, soy, licorice extract, and N-Acetyl Glucosamine, to name a few.

Retinoids and retinoid combination therapy

Retinoids, that are derivatives of vitamin A, are used to treat various pigmentation disorders like melasma and post-inflammatory hyperpigmentation, explains Dr. Markandeya. “It causes epidermal melanin dispersion and retinoids may also interfere with pigment transfer to keratinocytes and accelerate pigment loss by causing the epidermis to be shed more quickly,” she notes. “However, sideeffects in the form of erythema and desquamation are seen.”

Others

Studies, indicates Dr. Markandeya,have demonstrated good improvement in melasma with triple combinations of corticosteroids, hydroquinone and retinoic acid. “Retinoids reduce the atrophy of the corticosteroid and facilitate epidermal penetration and delivery of hydroquinone,” she says, however, irritant reaction causes paradoxical hyperpigmentation. Retinoids are not used in the commercial preparations used for hyperpigmentation.