Abstract
- Skin-lightening cosmetics are used by many women and men around the world.
- The products contain a variety of substances, which are often unknown to the users. Most of these products include topical corticosteroids, hydroquinone and mercury salts. Many other substances may be added.
- Several surveys and cohort studies, including several thousand individuals, have shown that regular application of skin-lightening cosmetics to large surface areas can have irreversible cutaneous adverse effects, such as patchy hyper- or hypo-pigmentation, skin atrophy, stretch marks and delayed wound healing, and can also mask or, on the contrary, promote or reactivate skin infections.
- Cases of skin cancer have been attributed to skin-lightening cosmetics.
- A Senegalese cohort study of 147 women showed a statistically significant increase in the risk of hypertension and diabetes linked to the use of skin-lightening agents.
- Other systemic adverse effects attributed to skin-lightening cosmetics include Cushing’s syndrome, adrenal insufficiency, nephrotic syndrome, neurological disorders, and ocular disorders. Hypersensitivity reactions, including anaphylaxis, have also been attributed to these products.
- Many skin-lightening cosmetics contain substances that can harm the unborn child. For example, tretinoin is teratogenic while salicylic acid is fetotoxic.
- In practice, users are often unaware of the risk of severe adverse effects associated with skin-lightening cosmetics. Users should be informed of these adverse effects and encouraged to stop using these products, especially when skin disorders appear.
©Prescrire 1 September 2011
"Skin-lightening cosmetics: frequent, potentially severe adverse effects" Prescrire Int 2011; 20 (119): 208-215. (Pdf, subscribers only)