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Let’s be Fair

Dr Shazia Ali

“The grass is always greener… While people in the West have been spending countless hours under the sun to attain a bronzed complexion even at the risk of getting skin cancer, people on our side of the pond (Middle East) are looking for skin lightening solutions to ditch their olive complexions—idiosyncrasies of human nature, go figure,” so tells us Dr. Shazia Ali, a dermatologist based in Jeddah, Saudi Arabia.

After picking up the Blanc de Chanel, a whitening cream geared towards the Asian and Middle Eastern markets, we couldn’t help but wonder about this phenomenon. “Skin tone correction and hydration are the secrets of dazzling skin, a translucent complexion, and a perfectly smooth skin surface,” the French Maison, whose illustrious Founder, Coco Chanel, was the first fashion industry advocate of tanning in the 20s, states in the press release.

Is white skin the right skin?

banner-for-whiteningEN

Margaret Hunter, an expert on skin color issues, explains the desire to be lighter complexioned. According to her, “colorism” is the process of discrimination that privileges light-skinned people over their darker-skinned counterparts. The contemporary colorism has its roots in the European colonization of Africa, Asia-Pacific, the Middle East, and the Americas, where light-skinned people are said to be offered more opportunities, status, and prestige—in nearly all these societies.

But let’s be fair—how are skin-whitening creams any different from tanning enhancers or bronzing lotions or anti-wrinkle creams? We asked Dr. Shazia Ali to help us make sense of this beauty trend.

How does skin whitening work?

skin whitening

You can lighten your skin tone (a shade or two) by getting rid of a tan acquired through careless or planned sun exposures, and you can also blend dark patches on your skin (due to hormones, acne, or other skin predispositions) to attain a more uniform complexion. But you can’t whiten your skin, at least not without causing serious damage to its vital structures.

Skin lightening products work by reducing a pigment called melanin in the skin. Most people who use lighteners do so to treat skin problems such as age spots, acne scars, or discoloration related to hormones. It is also a technique used to lighten naturally dark skin.

Skin lighteners contain an active ingredient or a combination of ingredients that reduce the amount of melanin production in the skin where it is applied.

The most widely used ingredient in skin lighteners sold around the world used to be hydroquinone. Recently, it has been banned in Europe because of its serious side effects over long-term usage. In the U.S., the FDA (U.S. Food and Drug Administration) regulates the use of hydroquinone (over-the-counter skin lighteners can contain up to 2% hydroquinone. Dermatologists can write prescription for lighteners that contain up to 4-6% hydroquinone). In the Middle East, its use is still uncontrolled and different percentages are available through over the counter sales.

Do you receive patients that come to whiten their skin? 

Of course I do—and by Rolls-Royce-and-Bentley-loads, if I may say so. Arab and Middle Eastern skin is more prone to pigmentation disorders.

I used to get patients walking in specifically with skin bleaching/whitening requests on a daily basis. They were always looking for a miracle cure to change their skin color completely.

When I explained to them that it is practically impossible to change your skin color completely without seriously damaging it, as complexion is a genetically determined trait, “How did Michael Jackson magically change his skin color permanently?” would be the counter question thrown at me. I had to explain over and over again that Michael Jackson had a skin condition called Vitiligo and that he opted to destroy all his pigment producing cells to blend his dark skin with the diseased colorless patches and that’s how he became the poster child for skin whitening.

Most of my patients come to me with complaints of hormone and sun-related pigmentation problems in addition to a unique complaint of dark elbows and knees, which is very indigenous to the Middle East and Indian subcontinent.

What is their motivation?

Every region has its indigenous beauty icons. In the Middle East, mostly the Lebanese, Syrian, or Egyptian (music or T.V.) celebrities are given “goddesses of beauty and attraction” status. As most of these people are fair skinned, all of our girls next door want to bleach their skin to match.

I also believe that the growing preference for white skin is not merely one of choice or aesthetics, but it seems to grow also from self-doubt and the lingering confusions of identity and acceptance. Spousal pressure and acceptance are also quoted as the main reasons by some of my patients seeking skin-lightening treatments.

 What are the risks of whitening?

When our skin is exposed to the sun, cells called melanocytes produce pigment to make a shield around the nucleus of the cells to protect it from carcinogenic mutations caused by the UVA & UVB rays. This pigment acts as a barrier shield protecting our skin from cancer and photo-aging.

Long-term use of skin lightening products can increase the risk of skin cancer due to sun exposure.

As with any new product, skin lightening products do come with some risks. It’s important to read the label and know the facts before you buy and apply a skin lightener.

Various bleaching agents, including natural ingredients, can cause skin irritation or skin allergies; for example, AHAs (alpha hydroxyl acids), high concentration of ascorbic acid (Vitamin C), and tretinoin (vitamin A).

Mercury Warning: Some people apply skin lightener to their entire body to change their complexion and this can be very risky. Regional Ministries of Health have reported the active ingredient in some skin lighteners (originating from Africa and Asia) can be mercury, and that using these products can lead to mercury poisoning.

Mercury is a toxic agent that can cause serious psychiatric, neurological, and kidney problems. Pregnant women who use a skin lightener with mercury can pass the mercury to their unborn child.

The use of mercury as an ingredient in skin lighteners is banned in Saudi Arabia, UAE, U.S.A., and Europe. However, some skin lighteners produced outside these regions may still contain mercury.

I always warn my patients to make sure there is no mercury in the skin lightening products they use. Mercury is sometimes listed under other names, such as calomel, mercuric, mercurous, or mercurio.

Steroid Warning: Some skin lighteners contain steroids. Using steroid-laced products can lead to increased risk for skin infections, skin thinning, acne, and poor wound healing.

ideal image of the arab woman

Applying steroids to large areas of skin can put you at risk for health problems related to steroids being absorbed by the body.

Hydroquinone Warning: Long-term use of Hydroquinone has been linked with unwanted and untreatable skin discoloration called ochronosis.

Is whitening more dangerous than tanning?

I don’t think whitening is more dangerous than tanning if tried under proper medical guidance. Over the years, tanning has been clearly linked with skin cancer. Dermatologists around the world are busy rallying and campaigning to warn against and stop the skin tanning trends.

Skin color (melanin) acts as a shield against skin cancer, that’s why we don’t see too many reported cases of cancer in darker skin types. Lighter skin is more prone to getting skin cancer and anybody using skin-lightening creams must remember that by losing skin color, they are losing their protective shield against harmful UVA and UVB rays. Hence, they must use sunscreen diligently and religiously.

brown skin

Which products do you recommend? 

I don’t advocate mindless skin bleaching. I usually tell my patients that no matter your skin color, it’s the quality and health of your skin that makes you look beautiful. In my opinion, color in the skin actually adds to a person’s attractiveness.

With regards to product choice, I prefer products that are hydroquinone or cortisone free.

I recommend products containing Vitamin C, niacinamide, arbutin, licorice extract, kojic acid, tretinoin, and azelaic acid.

I also strongly advocate use of sunscreen on a daily basis, even on cloudy days.

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