Safety of Whitening Treatments: Is it Worth the Possible Risk to Skin Health?

Text by Dr. Ces Hilario

With an immensely growing number of lightening and depigmenting products and treatments that may pose potential harm with use, an issue beckons to be answered: “Is white worth the price?”

Stemming from the history of Southeast Asia, a light complexion has long been regarded as noble and aristocratic. The saying “One white covers up three ugliness” has been passed through the generations. It has always been a salient obsession amidst the evolving standards in Asian history.

A survey in June 2004 carried out by market research firm Synovate in the Asia Pacific region, cites the Philippines with the highest usage (50%) of whitening interventions among the countries surveyed, followed by Hongkong (45%), Malaysia (41%), and Taiwan (37%).

Different depigmenting and lightening preparations from soaps, toners, lotions and pills, to various lightening treatment modalities like lasers, intense pulsed light (IPL), microdermabrasion, diamond peel, and chemical peels are among the many dizzying offerings of dermatology clinics, beauty salons, and aesthetic centers.

Here are the risks associated with each kind of whitening product or treatment:

Skin lightening agents
Among skin lightening agents, hydroquinone (HQ) is one of the most widely prescribed agents in the world. With reports of potential mutagenicity and epidemics of ocronosis, however, there has been an increasing impetus to find alternative herbal and pharmaceutical depigmenting agents, which are commonly perceived as safer options.

Among some of the skin agents, the tyrosinase inhibitors like kojic acid, arbutin, glycolic, and azelaic acid are well studied. Besides use in the treatment of some dermatological disorders associated with melanin hyperpigmentation, tyrosinase inhibitors have found an important role in the cosmetic industry for their skin whitening effect and depigmentation after sunburn.

Mercury salts in cosmetic products inhibit the formation of melanin in the skin, resulting in lighter skin tone. Consumers who are directly exposed to cosmetic products containing a certain amount of this substance run the risk of possible toxicity.

Recently, a lot of cosmetic products have been banned due to their highly toxic mercury levels, which can cause kidney damage, skin rashes, skin discoloration, anxiety, depression or psychosis and peripheral neuropathy. Chronic use reduces skin normal resistance against bacterial and fungal infection. The transfer of mercury to fetuses of pregnant women may manifest neurodevelopmental deficits later in life.

The use of glutathione (intravenously injected, orally taken, or as topical agent) has become a wildly commercial success, but its use and lightening effect remain debatable. Some adverse reactions that were noted and reported by the DOH-FDA are as follows: skin rashes, serious life-threatening skin conditions like Steven Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), derangements in the thyroid function, and kidney failure.

Chemical Peels
In a chemical peel, a solution is applied to the skin and allowed to soak in. The procedure destroys parts of the skin in a controlled way so that new skin can grow in its place. The types of chemical peel differ based on how deeply the chemical penetrates and what type of chemical solution is used. Deeper peels result in more dramatic effects but consequently pose higher risks, increased pain, and longer healing time. Chemical peels are done to improve the appearance of pigment changes in the skin, acne scars, sun damage and wrinkles.

Microdermabrasion and Diamond Peel
These procedures are relatively safer, and use minimally abrasive instruments to gently slough off the thicker, uneven outer layer of the patient’s skin. It improves hyperpigmentation and age spots. Most risks like bacterial infection and skin irritation are associated with performing these procedures under unsterile conditions or improper application of the treatments.

Laser skin resurfacing can either be ablative or non-ablative. Ablative lasers work to vaporize the affected tissue, removing the top layer of skin and part of the underlying sub-layer. Non-ablative lasers coagulate the affected tissue while keeping the outer layer of skin intact for further healing and recovery. Fractional skin resurfacing uses a combination of both ablative and non-ablative laser technique to produce a more effective result and faster recovery time.

Laser resurfacing technology has been proven to work with fast results on a number of skin problems including fine lines,wrinkles, erasing acne scars, repairing sun damaged skin, and minimizing the appearance of dark spots.

Possible side effects include redness and swelling after the procedure, skin blistering, cold sore reactivation, scarring, hyperpigmentation and hypopigmentation.

Intense Pulsed Light (IPL)
Using specific light filters, the energy of the IPL can be focused on a specific target within the skin. Research shows that it has lightening effect both on pigmentations and normal areas of the face. Some complications are redness, swelling, increased visibility of capillaries, darkening or whitening of the skin due to improper use of IPL device. In essence, possible risks are inevitable in whatever we put on our skin or feed to our body. Thus, the question “Is white worth the risk?” can only be answered by the individual. Personally, as long as one reads the label, is aware of the various components and possible adverse effects, and then chooses the appropriate lightening treatment option, and of course seeks consultation with a skin specialist or dermatologist who has the proper training, knowledge and experience, then, white …why not?


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