In a recent press release from the American Academy of Dermatology (AAD), board-certified dermatologists from the AAD expressed concerns about the growing trend of skin lightening and the unintended health consequences of pursuing lighter skin at any cost. The press release notes that at the AAD Virtual Meeting 2021, board-certified dermatologist Seemal R. Desai, MD, FAAD, clinical assistant professor of dermatology at the University of Texas Southwestern Medical Center, discussed the global increase in skin bleaching and the risks to consumers' health. "The cultural beliefs that promote the practice of skin bleaching date back centuries and deeply affect many of our patients with skin of color," Dr. Desai stated, adding, "It's going to take time to change these deeply-rooted cultural values and psychological associations with lighter skin tones; however, we want to educate patients about the dangers of skin bleaching strictly for the sake of achieving lighter skin and encourage them to talk with their dermatologist so that we can begin changing this dialogue."
The AAD press release states that although bleaching creams can be used safely under the direction of a board-certified dermatologist to treat pigmentary conditions such as melasma, dermatologists are concerned about the use of these products to change one's complexion. Skin bleaching usually refers to the practice of using OTC (and online) products advertised to lighten dark skin to achieve a lighter complexion. Dermatologists also note that some skin-bleaching products not regulated by the FDA make their way to the U.S. from other countries and are sold online, and that these products may contain dangerously high concentrations of hydroquinone and topical steroids. The combination of these two drugs halts the creation of melanin in the skin, which could cause other complications.

Dr. Desai remarked that the use of these unregulated products can have devastating consequences and that dermatologic rashes, steroid-induced acne and subsequent scarring, thinning skin, and skin ulcers have been associated with the use of skin-bleaching products that consumers do not purchase in U.S. drugstores. Moreover, according to Dr. Desai, "The bottom line is that skin bleaching products that consumers are purchasing online and overseas may not be safe. In some cases, ingredients aren't listed on the package, which should be a big warning sign to stay away. Although rare, there have been reports of mercury and arsenic in skin bleaching products."

He also stated that in some cases, individuals using skin-bleaching products develop a condition called exogenous ochronosis—a rare but permanent adverse effect in which blue and purple pigmentation appears after long-term use of bleaching creams containing hydroquinone. Finally, Dr. Desai expressed the following sentiment: "Many people with skin of color will go to great lengths and incur great costs to change their skin tone. It's time to stop the spread of poisonous information that perpetuates beliefs that lighter skin equals more beautiful skin whether it's through product marketing or social media and begin to empower consumers to feel beautiful and comfortable in their own natural skin color." 

The AAD recommends that patients with pigmentary conditions that create uneven skin tones, such as melasma and postinflammatory hyperpigmentation, seek medical advice from a dermatologist.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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