Skin lightening involves the use of topical products that contain corticosteroids, hydroquinone, mercury and/ or variety of other agents to attain a lighter skin color.
Why lightening the skin?
1.Some people do it because they dont like been dark, others say it give them self confidence, others say it helps them fit into a certain social class…Are these reasons really worth it? Let’s find out?
- Is the use of SLC a public health issue?
Skin bleaching as a public health crisis is an under studied area of public and efforts to prevent injuries to skin or skin safety has received little or no attention despite the increasing casualties especially in Nigeria and Africa as a whole. Skin damage due to skin bleaching is one of the most common form of harmful body modification practices worldwide that has receive little research attention. Obtaining prevalence rates in Nigeria is challenging because of how lighter skinned persons are been perceived or rewarded.
The cosmetic use of SL products has been found to be common in Africa, Asia and many other parts of the world. Globally, The prevalence of the use of SLC is about 27.7%, with Africa having an estimated Prevalence of 27.1% and has become a serious public health issues. Certain countries even placed a ban on the use of SLC for cosmetic purposes. Unfortunately, the use of SLC in Nigeria is not regulated and because although expensive, anyone in need of it can randomly get it from cosmetic stores, pharmacies and supermarkets.
According to WHO report in 2011, an estimate of 77% of Nigerian women use SLC regularly I.e 3 in 4 women use SLC.
Examples of SL agents
They include hydroqunione, glutathione, mercury, hydrogen peroxide, steroids , Kojic acid and other natural agents.
Adverse effects of the use of SLC
This can be cutaneous (topical) or Systemic
Cutaneous AE includes acne, unwanted and untreatable skin discoloration, skin thinning, poor wound healing, skin irritations or allergic reactions, premature aging of the skin, skin infections, excessive hair growth(hirsutism)
Systemic AE includes osteoporosis, Cushing’s syndrome, diabetes, hypertension, infertility, birth defects.
Specific adverse effects of mercury
Kidney damage , skin rashes, skin discoloration and scarring, reduced ability to resist bacterial and fungal infections (in immunocompromised cases*), anxiety, depression or psychosis, peripheral neuropathy.
Mercury and Reproductive health of women
In july 2019, a 47 years Mexican-American woman having used SLC for 7 years presented with feeling of funny sensation and weakness in her arms which later progressed to slurred speech , blurry vision, difficulty in walking and left her dependent on feeding tube to eat.
Significant percentage of SLC contains mercury with females being its highest users. Studies have highlighted the use of SLC containing mercury in women during and after pregnancy to remove dark spots. Women, especially pregnant and lactating mothers using SLC are at risk of Hg poisoning because sometimes it has no clinical symptoms , particularly during early exposure. Studies have shown that prenatal and post natal Hg exposure can cause permanent neurological damage in children. Furthermore, it can women infertility and birth defects. Animal studies carried out in mice shows that long term exposure to SLC can cause accumulation of Hg in ovaries causing ovarian failure that leads to infertility or birth defects.
In women, infertility is influenced by an imbalance of female hormonal system. The progesterone/oestrogen ratio change in favour of increase oestrogen level which inhibits the release of LH . Thus Hg may induce famine infertility by increased prolactin secretion( hyperprolactinaemia). Hg exposure has also been associated with Polycystic ovarian syndrome, premenstrual syndrome, dysmenorrhea, amenorrhoea, early menopause, endometriosis, Benign breast disorders, galactorrhea often associated with female infertility. Hg crosses the placental barrier and reaches the foetus causing developmental defects. Hence, women of reproductive age, pregnant or lactating mothers should avoid even minimal contact with mercury.
Women should resolve to the use of normal skin creams and avoid SLC except it’s been prescribed by a dermatologist.