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Skin bleaching creams linked to diabetes

by  Sola Okenla, RN, BSNThe Grio
October 4th, 2012

Use of skin bleaching creams may increase the risk of developing diabetes and other diseases, according to a study in Canadian Family Physician.

When walking into many pharmacies or beauty supply stores, particularly in urban communities, the sale of skin lightening products is quite rampant. Brands such as Ambi and Porcelana advertise the potential for consumers to lighten and balance uneven skin tone, with hopes of appearing more attractive.

Hydroquinone is the commonly used active ingredient in many of these bleaching creams.

This chemical works by stopping the production of melanin, which is responsible for the darkening of a person’s skin tone. But, Dr. Neelam Vashi, a dermatologist at Boston University Medical Center believes that hydroquinone is a safe skin-lightening product.

“I believe that when used appropriately, and under physician’s guidance, and with proper sun-avoidance, I think hydroquinone is a safe and effective method of skin lightening,” Vashi said.

However, Vashi does warn that there are side effects of the long-term use of hydroquinone products.

“The most severe and widely recognized side-effect of chronic hydroquinone [use] is called exogenous ochronosis, which is a paradoxical darkening of the skin, and it happens when hydroquinone is used at high concentrations for several years,” she said.

Symptoms of exogenous ochronosis include blue and grayish hyperpigmentation and bumps on skin.

Although hydroquinone has been banned in several countries, including Japan, the European Union, and Australia, the over-the-counter sale of this product is legal in the United States.

According to the Food and Drug Agency, the legal maximum percentage for over-the-counter hydroquinone-based products in the U.S. is 2 percent. However, there have been several instances where certain bleaching products contain an illegally higher concentration of 4 percent of more.

There have also been cases where certain lightening creams contain extremely powerful prescription-strength steroids.

Bleaching creams like Dermovate, Movate, Top Gel, and Nuvotone have been found to contain the potent steroids betamethasone and clobetasol propionate.

Clobetasol is commonly prescribed by dermatologists for skin conditions like psoriasis, eczema, and vitiligo.  A major side effect of this drug is hypopigmentation, or skin lightening. The skin lightening effect of clobetasol has made it a desirable product for avid skin-bleachers.

However, consumers of this steroid not only risk skin complications, but they also chance the development of diabetes and other endocrine disorders.

Vashi states that “with high-potency topical steroids used for a long time you can get suppression of the hypothalamic-pituitary-adrenal system. And with that suppression you can get these endocrine problems like Cushing’s disease and diabetes.”

African-Americans have an increased risk of developing diabetes, and topical steroids would heighten their risk dramatically.

Cushing’s disease, which affects all races, is another disorder that develops after prolonged use of steroids like clobetasol. Symptoms of Cushing’s disease are excessive weight gain, a round swollen face commonly referred to as “moon face,” and thinning skin that is easily prone to bruising and ripping.

According to a 2006 study in the Journal of the National Medical Association, many people, particularly African-Americans and African immigrants, abused topical steroids such as like clobetasol, as a cosmetic means to lighten their skin.

The study showed that many of the bleaching creams were sold to the participants in nonmedical stores, and had no mention of adverse side effects or warnings. Some of the subjects developed complications including skin infections, high blood pressure, diabetes, and widespread stretch marks.

Complications from skin bleaching are not only unhealthy for the suffering individual, but may also be offensive to those around the person.

In a 2008 study in the International Society of Dermatology, it was revealed that people who bleach their skin over a prolonged period of time develop body odor resembling rotten fish, called “fish odor syndrome.”

This syndrome is due to the excretion of a chemical called trimethylamine in the sweat, saliva, urine and vaginal secretions.

Despite the negative side effects of skin bleaching, the skin bleaching industry is estimated to gain a profit of $10 billion dollars globally by 2015.

Dr. Oon Tian Tan, a Chinese dermatologist at Massachusetts Eye and Ear Laser Center says she has seen many clients who desired lighter skin for social gain.

“My Asian clients love lightening.  Because to them, fair skin means a life of luxury where you don’t have to work out in the field.  So they love these bleaching creams,” she said.

Debbie Saint-Clair, a 26-year-old Haitian-American executive assistant, says she does not use skin-lightening creams, but understands why others do.

“I think the consensus throughout the world is that lighter skin is the best. People are taught at a young age that lighter skin is better, and some are willing to do whatever it takes to achieve that,” she said.

Jenny Matthews, a 26-years old African-American woman adds “with modern developments in science and medicine, it’s easier for the masses to align themselves with what is advertised as beautiful.”