Complications of chronic use of skin lightening cosmetics

Abstract

Skin lightening (bleaching) cosmetics and toiletries are widely used in most African countries. The active ingredients in these cosmetic products are hydroquinone, mercury and corticosteroids. Several additives (conconctions) are used to enhance the bleaching effect. Since these products are used for long duration, on a large body surface area, and under hot humid conditions, percutaneous absorption is enhanced. The complications of these products are very serious and are sometimes fatal. Some of these complications are exogenous ochronosis, impaired wound healing and wound dehiscence, the fish odor syndrome, nephropathy, steroid addiction syndrome, predisposition to infections, a broad spectrum of cutaneous and endocrinologic complications of corticosteroids, including suppression of hypothalamic-pituitary-adrenal axis. In this era of easy travels and migration, African patients with these complications can present to physicians anywhere in the world. It is therefore critical for every practicing physician to be aware of these complications.

Non-toxic melanin production inhibitors from Garcinia livingstonei (Clusiaceae)

“…A range of topical agents are available to treat hyperpigmentation and act at different levels of the melanogenesis pathway (Kanthraj, 2010;Sheth & Pandya, 2011). The most common synthetic pharmacologic agents used are hydroquinone, corticosteroids, and mercurials (Olumide et al, 2008). The long-term use of these products may cause undesirable cutaneous or systemic side effects (Findlay et al, 1975;Findlay & de Beer, 1980;Olumide et al, 2008).…”

“…The most common synthetic pharmacologic agents used are hydroquinone, corticosteroids, and mercurials (Olumide et al, 2008). The long-term use of these products may cause undesirable cutaneous or systemic side effects (Findlay et al, 1975;Findlay & de Beer, 1980;Olumide et al, 2008).…”

“…(Draelos, 2007;Sheth & Pandya, 2011). However, its use has been associated with various side effects, which include irritant contact dermatitis and exogenous ochronosis (Findlay & de Beer, 1980;Hardwick et al, 1989;Olumide et al, 2008). In 1975, Findlay and co-workers reported ochronosis amongst black South African women after prolonged use of skin lightening creams containing p-hydroquinone, which inhibits tyrosinase and prevents the conversion of tyrosine to dihydroxyphenylalanine, a precursor of melanin.…”

Aplicação da dermatoscopia no auxílio diagnóstico da ocronose exógena

“…8 Other complications resulting from the chronic use of hydroquinone include depigmentation in cofeti, change in skin elasticity and delayed healing. 9 In the reported cases all used hydroquinone, with average treatment time of four years (3 to 5 years) and average concentration of 4% (6% to 2%). Some reports describe cases of EO with use of concentrations of hydroquinone 2%, suggesting that in some patients the concentration of the substance is not the most important risk factor.…”

Simultaneous Determination of Hydroquinone, Kojic Acid and L-Ascorbic Acid in Some Cosmetic Emulsions

“…These agents are known to reduce hyper pigmentation when in proper use but can destroy the skin reducing its elasticity, inhibiting melanogenesis and destroying melanocytes [9] when improperly administered. This then results in the permission of harmful ultra violet rays into the dermis, eventually resulting in cancer of the skin [10,11,12].…”