If you have heard about skin bleaching before, it has been probably been in a negative capacity. With the widespread visibility of ways that skin bleaching medicines and products can be misused — think about the accusations surrounding baseball player Sammy Sosa, for instance — the medicinal uses of skin lightening are often obscured or unexplored.

 

To demystify skin bleaching, I spoke with Dr. Andrea Kassim, a board certified dermatologist with training in both cosmetic and laser surgery, to get the low down. Here’s everything you should know: how it works, the pros, and the possible negative effects. Dr. Kassim stressed that you should only undergo skin lightening treatments after consulting with a skin care professional.

 

1. Contrary to the stereotype that skin lightening is purely cosmetic,dermatologists actually prescribe skin bleaching meds to their patients for skin disease. Generally speaking, most people feel more confident with clear, even skin. For many, the battle with skin disease can be a real hurdle that must be overcome to achieve this goal. That’s why dermatologists prescribe skin lightening medications to treat various common cuteanous diseases that lead to unevenness or discoloration. “One of the most frequent reasons patients are prescribed skin bleaching medicines is to treat post inflammatory pigmentations that can happen to anyone,” Dr. Kassim explained.

Post inflammatory pigmentation — dark spots that appear because of injury to the skin or inflammation like acne — can be faded by applying the medicine to affected areas.Melasma, the appearance of discolored patches on the face, typically triggered by hormonal changes during pregnancy and by sun exposure, also responds well to skin bleaching. In many other cases, skin lightening may even help to reduce the visibility of age spots, moles, birthmarks and scars.

2. There is actually no bleach involved in skin lightening.

Skin bleaching medicines work by reducing a pigment called melanin. By applying the medication to hyper-pigmented areas — parts of the body or face that are visibly darker than others — melanin production is disrupted allowing the skin to lighten and become more uniform. Sometimes, skin lightening products can include exfoliants that induce mild peeling. Since skin tends to regenerate quickly and easily, the peeling helps to clear away dead cells and resurface fresher and lighter layers beneath.

3. But skin lightening can have harmful side effects.

For the treatment of common skin diseases, dermatologists typically recommend the short term use of Hydroquinone — an over the counter or prescription cream with a max dose of 2% that is FDA approved, but still happens to be a bit controversial. Usually, serious allergic reaction to the Hydroquinone is rare, though users may sometimes experience mild redness, dryness or itching of the affected area. However, according to Dr. Kassim, “there is evidence to suggest that certain skin-whitening medicines, like hydroquinone, contain ingredients which may have carcinogenic properties that can be harmful.” In other words, the drug may increase risks of cancer. For that reason, though available over the counter in low doses in the United States, Hydroquinone can only be obtained by prescription from a doctor in many countries. It was even banned for a while in Europe but is now once again attainable by prescription only.

4. There are huge consequences to abusing skin lightening meds.

We have all likely seen celebrity skin bleaching jobs gone wrong and what overly bleached skin can look like: unnaturally white with a grayish, very dull tint. However, the corpse-like skin is not even the worse of it. When Hydroquinone is used in doses higher than 2% or over a period longer than three months, the whole skin lightening business can have some pretty negative, even paradoxical results. “With higher concentrations of the medicine, there have been reports of the development of exogenous ochronosis, the darkening of the skin which is permanent and very resistant to any treatment,” Dr. Kassim explained. Though there is a possibility that this skin reaction can develop with lower doses, the risks are increased when the dose is higher.

Overuse of skin whiteners can also cause pigmentation to build up in your extremities (fingers, toes, ears etc), causing them to look darker and mismatched. Yet another negative reaction can develop known as the “bleach panda effect”, where the skin on the face becomes thinned around the eyes and have increased pigmentation. Cute on a panda, not so much on a human.

5. Natural skin lightening options exist as well.

For those wary of harmful chemicals, explore natural remedies to lighten skin. “There are many naturally occurring agents that can be found in nature that have lightening properties,” Dr. Kassim explained. Chemical-free and easy-to-find alternatives to over the counter or prescription skin lightening products include Vitamin C, topical creams with Azelaic acid (a component of grains like wheat and barley)and the Chinese herb Cinnamomum Subavenium. There is also some research to suggest that pomegranate extract and vitamin E oral supplements may also inhibit melanin production.

For less extreme cases of skin tone unevenness, a simple peel or daily exfoliant may do the trick. If money is not a problem, look for toxin-free skin lightening products currently available on the market: They tend to cost a bit more because they have expensive ingredients, but they may be less abrasive and harmful.