phenomenon of skin lightening: Is it right to be light?

Abstract

Chemicals capable of lightening the skin – variously known as skin-bleaching, skin-lightening, depigmenting, skin-evening and skin-brightening agents – are among the most commonly used skin preparations in the world. Globally, Africa reportedly exhibits a high prevalence of skin lightener use. In this review, we provide both clinical and social perspectives on skin lightener use in Africa, with particular emphasis on South Africa. We narratively explore the timeline associated with skin lightener use in South Africa and attempt to interweave the social rhetoric of this specific paradigm. Despite the risks associated with exposing the skin to known constituents of these formulations, such as hydroquinone and mercury, chronic use continues. In spite of legislation banning hydroquinone and mercury in cosmetics in South Africa, these ingredients are present in widely available products. We recommend better implementation of policies and greater ethical responsibility of multinational cosmetic companies in addition to the initiation of a system of random product testing and penalties that could improve industry compliance.

The global prevalence and correlates of skin bleaching: a meta‐analysis and meta‐regression analysis

“…We conducted, to our knowledge, the first ever meta‐analysis and meta‐regression analysis of the global lifetime prevalence of skin bleaching. The overall lifetime prevalence obtained after imputation (27.7%) provides empirical indication of a high global prevalence of skin bleaching practice, in line with suggestions from previous reviews as well as estimates from fiscal and trend analysis of the skin bleaching market . Even though males reported a high lifetime prevalence (35.2%), the sex difference in terms of lifetime prevalence did not reach statistical significance, suggesting that skin bleaching is a unisex practice.…”

“…Even though males reported a high lifetime prevalence (35.2%), the sex difference in terms of lifetime prevalence did not reach statistical significance, suggesting that skin bleaching is a unisex practice. Additionally, the association of only the proportion of females in study samples with skin bleaching prevalence in the meta‐regression analysis is consistent with the truism in the field …”

“…Many skin bleaching practitioners report experiencing benefits such as perceived increase in attractiveness, confidence and self‐esteem, relief from bodily blemishes, and better appreciation from spouses . Conversely, long‐term skin bleaching and the use of toxic and highly potent agents has been associated with various harmful outcomes varying from dyschromia to more worrisome systemic side effects including diabetes and hypertension . As a result of these associated harms, the practice of skin bleaching is a public health concern, and the importation and marketing of skin bleaching products has consequently been banned or is strongly regulated in many African, Asian, European, and North American countries…”

“…Besides summarizing available literature on a topic, a meta‐analytic review has other advantages in terms of statistical methods for combining results from included studies and presenting overall findings, as well as investigating factors that account for between‐study variance through a meta‐regression analysis . Some previous reviews have been conducted on the skin bleaching literature . However, with one exception, past reviews have been merely narrative and unsystematic.…”

“…However, with one exception, past reviews have been merely narrative and unsystematic. Further, although several epidemiological investigations have been conducted on skin bleaching practice in various parts of the world, to our knowledge, no previous review has quantified through a systematic and meta‐analytic approach the global prevalence of skin bleaching.…”