Skin Lightening

The use of bleaching products can have a medical or cosmetic purpose; in the latter case, skin whitening is most widespread in countries where darker skin tones prevail and can be driven by psychosocial, cultural and economic reasons. Skin-whitening products containing highly toxic active ingredients (in particular mercury derivatives, hydroquinone and corticosteroids) are easily found on the market; the use of these depigmenting agents can be followed by a variety of adverse effects, with very serious and sometimes fatal complications, and is currently an emerging health concern in many countries.

Skin lightening is defined as ‘the practice of using chemicals or any other product with depigmenting potential in an attempt to lighten skin tone or improve the complexion; these goals are achieved by decreasing the concentration of melanin to achieve a reduction in the physiological pigmentation of the skin.

Products used to achieve this purpose are known as depigmenting, skin-lightening, skin-bleaching, skin-brightening or skin-evening agents. Several skin-lightening compounds have been developed and are now available for pharmaceutical and cosmetic purposes.

Therapeutic indications for skin-lightening agents are generally aimed at the management of pigmentation disorders such as discolouration due to hormonal changes, melasma, age spots, senile/solar lentigo, post-inflammatory hyperpigmentation, and pigmented acne scars, as they reduce the hyperpigmentation of specific areas of the body and provide a more uniform skin colour. However, skin lightening is primarily a cosmetic procedure whose function is not only to lighten dark areas of the skin but also to achieve a generally lighter tone, particularly in countries where darker skin tones are prevalent and voluntary depigmentation meets the aesthetic criterion of a lighter skin.

Skin-lightening agents can operate through different mechanisms: the inhibition of tyrosinase transcription (e.g., Tretinoin, Retinol), the inhibition of tyrosinase (e.g., Hydroquinone, Azelaic Acid, Resveratrol), the acceleration of epidermal turnover (Lactic Acid, Glycolic Acid), the inhibition of melanosome transfer from melanocytes to surrounding keratinocytes, anti-inflammatory action and scavenging of free radicals, all of which have tyrosinase inhibition as their common goal.

Many effective depigmenting compounds available today can only be used as drugs (e.g., Hydroquinone, Retinoic Acid) and should be restricted to use under dermatological supervision, while others are permitted in cosmetic products (e.g., alpha-hydroxy acids (AHAs), Arbutin, Retinol, Ascorbic Acid). The development of new inhibitors of melanogenesis is of great importance in both the pharmaceutical and cosmetic industries. These inhibitors can originate from different sources, such as chemical synthesis and the screening of natural compounds and extracts. In particular, the search for new whitening ingredients is driven by the demand for natural products, and traditional herbal derivatives are currently being investigated, as they are generally believed to be safer than synthetic compounds.

Since ancient times, the canon of beauty has included a very fair complexion. During the 7th century in China, Empress We Zetian swallowed crushed pearls to obtain her fair complexion, a practice still popular among Chinese women. Greek women painted their faces with white lead (lead carbonate, very toxic) and Roman women adopted this practice using the same compound, which they called ‘Cerussa’, as described by Pliny the Elder. Cleopatra (69–30 BC), queen of the Ptolemaic kingdom of Egypt, regularly bathed in acidic ass’s milk. In different historical periods, there have been many reasons behind skin-lightening practices; they are linked to colonialism in countries such as Africa or India and slavery in America.

Dangerous skin-whitening practices are not limited to the past, and the search for means to obtain a white complexion has continued unabated in the following centuries; striking examples are the ingestion of arsenic waffles in Victorian times, the use of radiotherapy at the beginning of the 20th century, or even, very recently, the oral or intravenous administration of Glutathione recommended in some African countries to pregnant women to lighten the skin of babies in the womb. Although Coco Chanel made the tanned complexion fashionable in the 1920s, there are still several psychosocial, cultural and economic reasons why people lighten their skin, because light complexion is still perceived as a positive value in many countries and cultures.

This prejudice has its origin in so-called colourism; although colourism and racism are often interconnected, they are two different phenomena. Racism is prejudice against people of a certain ethnic group or “race”, while colourism can be defined as “prejudice or discrimination against individuals with a dark skin tone, especially among people of the same ethnic or racial background”, as defined by the Oxford English Dictionary.

Dangerous examples are:

Mercury - the main sources of mercury exposure in the past were industries (such as felt hat factories) and the composition and subsequent intake of mercury-based medicines. The use of mercury-containing skin-lightening products is currently a major cause of chronic mercury poisoning in some areas of the world; despite their limited effectiveness, toxicity and the fact that they are banned in many countries, these products are still available.

The toxic effects of topically applied mercury-containing products have been documented since the beginning of the 20th century. Acute or chronic exposure can result in dermal, gastrointestinal, neurological and renal toxicity. Organic and metallic mercury, which is more lipophilic, is more typically associated with neurological damage, while inorganic mercury more often causes kidney damage. Dermatological effects include allergic contact dermatitis, redness, erythroderma, nail discolouration, purpura and paradoxical hyperpigmentation

Hydroquinone - Interest in hydroquinone as a skin-lightening agent arose in the 1960s following the accidental discovery of its skin-whitening effect on black American workers who were exposed to it on a daily basis in the rubber industry. Hydroquinone’s use for depigmenting purposes became widespread in the following decades and is currently utilised in managing various hyperpigmentation disorders such as melasma, chloasma, freckles, age spots and post-inflammatory hyperpigmentation caused by acne or trauma. Hydroquinone is present in numerous prescription-only preparations.

The use of skin-lightening products containing hydroquinone can cause short- and medium-term effects, both acute and chronic. The most common acute complication is irritant contact dermatitis. Chronic side effects due to hydroquinone exposure are of more concern and include ochronosis, nail discolouration, conjunctival melanosis and corneal degeneration; however, ocular complications only occur in individuals exposed to atmospheric hydroquinone and have never been reported after topical application of the compound. The most common complication induced by prolonged exposure to hydroquinone is exogenous ochronosis, a localised hyperpigmentation of the skin with asymptomatic blue-black and grey-brown macules with no systemic manifestations, histologically characterised by banana-shaped ochre deposits and irregularly shaped collagen bundles in the dermis.

Corticosteroids - Topical corticosteroids are among the most widely prescribed drugs in clinical dermatology; they are used in the management of a wide range of medical conditions, due to their anti-inflammatory, antimitotic and immunomodulatory actions. Abuse of topical corticosteroids, with the aim of achieving lighter skin, is a widespread practice in many countries, such as India and sub-Saharan African states, especially among women. The misuse of these products is facilitated by their availability as cheap over-the-counter (OTC) drugs.

The cosmetic use of corticosteroids is associated with a wide range of side effects, both dermatological and systemic; these adverse effects are directly connected to the potency of the compounds, since steroids used as lighteners are generally classified as potent or very potent. Skin complications include acne vulgaris, allergic contact dermatitis, skin atrophy, hypertrichosis and telangiectasias.

In addition, topical corticosteroids predispose to skin infections, such as dermatophytosis, folliculitis, erysipelas, scabies and viral warts. Systemic adverse effects due to chronic corticosteroid use include Cushing’s syndrome, diabetes mellitus, immunosuppression, hypertension, and suppression of the hypothalamic-pituitary-adrenal axis with adrenal suppression, the latter being the most alarming complication, as it can lead to death.

The circulation on global markets of lightening cosmetics containing illegal and toxic ingredients is now a growing public health concern; products containing banned ingredients are readily available in many countries and sold both in traditional shops and online, despite all of the strict regulations currently in force. Addressing this problem requires a multi-faceted approach, as it encompasses several aspects. First, existing national regulations should be more strictly enforced, and more should be done at an international level to reduce the circulation of illegal skin whitening products, especially with regard to online sales.

Secondly, further studies are needed on the toxicity of skin-lightening ingredients of major concern for human health, since final users often apply self-made mixtures of different products with sometimes unpredictable toxic effects. Scientists should also expand their focus to the long-term health effects of undue skin-lightening practices, such as cancer; it cannot be excluded that an excessive inhibition of melanogenesis can result in an increased susceptibility to skin cancer in darker populations living in tropical countries due to UV radiation.

Not my own work. Taken from: (Italics, here, are mine)

Juliano, C.C.A. Spreading of Dangerous Skin-Lightening Products as a Result of Colourism: A Review. Appl. Sci. 2022, 12, 3177. https://doi.org/10.3390/app12063177

Copyright © 2026 by the author(s).

The above is taken from an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

File Note: I would like to add that all products listed on my website for lightening or brightening, that are commercially available from skinperfection.co.uk comply with EU Regulation 1223/2009 which banned the use of hydroquinone, mercury and topical steroids in skin-whitening cosmetics; in particular, corticosteroids and mercury and its compounds (except phenylmercury salts, listed in Annex V of Regulation 1223/2009 and which are allowed as antimicrobial preservatives in eye products). All products sold also comply with Annex II, (the list of substances prohibited in cosmetic products) in that none of those substances are contained in any of the products sold by us.