MORE THAN SKIN DEEP

Medically, lightening your skin really isn’t good for it

When New York rapper Azealia Banks took to Facebook this month to defend her use of skin-lightening products, she came armed with claims of hypocrisy.

“To say that [skin bleaching] negates what I’ve been saying about blackness in America is ignorant and just stupid,” Banks said (the video, up on YouTube, has since been removed from Facebook). “Nobody was upset when I was [wearing] 30-inch weaves, tearing out my edges, and doing all types of s—t like that. You guys loved it, but what is the difference?”

The cultural implications of skin-lightening can, and have, been debated at length—earlier in the video, Banks says it’s “really not important to discuss the cultural significance of skin-bleaching anymore because….as black people in this world, you assimilate.” But the primary difference between skin-bleaching products and more routine cosmetic procedures is medical: Lightening your skin is really not good for it.

Skin-lightening products contain a chemical called hydroquinone. In the US, dermatologists can prescribe creams or lotions containing about 4% hydroquinone for patients with skin conditions, and some products approved for over-the-counter use contain 1.5% to 2% hydroquinone. These creams are topical, and partially block a chemical reaction in our skin that produces melanin. Melanin gives our skin (and eyes and hair) pigment; less melanin means lighter skin.

But hydroquinone has some serious side effects. The chemical has been linked to permanent skin bleaching and cancer in rodents who ingested it, as well as (ironically) excessive skin-darkening or permanent stretch marks. Additionally, many skin-lightening products contain prescription-strength steroids, which can cause acne and the thinning of the skin to the point where veins and bruises show easily.

In 1982, the US Food and Drug Administration (FDA) found products containing legal amounts of hydroquinone to be safe and effective, but the agency reversed course in 2006, naming hydroquinone a possible carcinogen. The FDA called for additional testing, noting that hydroquinone products could remain available over the counter pending additional information. The agency hasn’t changed its position since. Meanwhile, hydroquinone has been heavily regulated or outright banned in the European Union, Australia, Japan, and Cote d’Ivoire. A new law banning such products in Ghana takes effect next month.

But skin-lightening continues to be popular—creams, lotions, and soaps remain common in some Hispanic, Asian, Indian, and black communities—and many of the available products have hydroquinone levels outside recommended limits. Last month, researchers from the University of Montreal in Canada found (paywall) that the majority of skin-lightening products sold in markets in west Africa or small shops in Canada contained more than the recommended amount of hydroquinone. More alarmingly, 61 of the 191 products they sampled contained levels of mercury higher than the safe limit established by the US FDA. Mercury is a heavy metal that can be damaging to the kidney, the central nervous system, and fetuses in pregnant women. In 1990, the FDA banned a skin-bleaching cream called ammoniated mercury.

“Our results indicate that most studied skin-lightening products are potentially toxic and that product labels are frequently inaccurate with respect to the presence of toxic agents,” the University of Toronto researchers wrote.

While objections to skin-lightening are generally based on the practice’s racial roots, scientifically such products are caught between the strict regulations applied to medicine and the more lax ones applied to cosmetics. Dermatological creams are generally intended for use on small areas, and require a follow-up visit after four to eight weeks.

“From a medical perspective, we prefer to [prescribe] in a controlled setting,” says Steven Xu, a dermatologist at Northwestern University in Illinois. “[But] products that are marketed as cosmetics have less scrutiny.”

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