If man were to craft himself, he would place himself in the cradle of perfection. Intriguingly, the said creation is a gift for some, who fit the description of Adonis-esque beauty, chiseled to exquisiteness. But a burden for many who shall always be below the set standards of societal expectations when it comes to appearance. Such is the case of the color of one’s skin. It is yours to bear since the moment you enter the world, from the day you are born to the day you depart this world, your color is your distinction from the rest. However, what is largely ignored is the fact that man isn’t born with prejudice or dislike against a certain color, it is what’s instilled in his mind from the surroundings he is born into and that is something that can unfortunately, not be helped.
In a country like Pakistan, a country born from the shackles of colonialism and slavery, has led it to develop a sort of a complicated national schizophrenia when it comes to color. Modern Pakistanis would like to pretend that the extended British rule hasn’t left any of its effects, almost a century later, but it is an utter lie which is often believed to placate one’s self. The pure worship of individuals of paler skins, deeming them to be a rank slightly higher than others, which was quite dominant in the recent decades after the British gave up the subcontinent, has still left its remnants. Those remnants can be observed in the slight jabs that the older generation takes at a woman whose color is towards the darker spectrum. In the jokes that are offensive but are brushed off as funny, in the sense of superiority that the people of lighter color have in this country is what makes the skin color of an individual a topic which is constantly under discussion.
Furthermore, having a lighter complexion is something that many individuals aim for as it helps boost their confidence and makes them feel better about themselves. Especially in our society, individuals with fairer complexions tend to have higher confidence levels and an elevated self-esteem. Unfortunately, it is also linked with better job opportunities and an increased tendency to be favored in social settings. This bias is much deeper rooted when it comes to females of the society. For them, a fairer complexion means a better standing among peers, a better sense of self and a better chance of securing jobs.
With that being said, there is a substantial number of people who are interested in getting a lighter skin tone. For such interested consumers, there are many treatments available which can be trusted for reliable results. In order to understand the treatments, let’s first have a look at what skin whitening basically is.
Skin whitening is the process by which people reduce the melanin pigment in the skin to give a whiter complexion. The amount of melanin in a person’s skin is responsible for their complexion, therefore, the darker the person, the more melanin is there in their skin. Melanin is manufactured by cells called melanocytes. The melanin quantity of a person’s skin depends upon the genetic buildup while the production of melanin is affected by exposure to the sun, the degree of damage to the skin and exposure to chemicals.
Oft-times, people take recourse to skin whitening methods to deal with common problems such as freckles, age spots, scars, moles, acne, birthmarks etc. But the most interested are the people who wish to have fair skin, especially those with a darker shade of skin. Most often than not, people use whitening or lightening products such as bleaching creams, fading creams or fairness creams. These products work by disturbing the tyrosinase enzyme which is instrumental for the melanin production and thereby reducing its amount in the skin. The melanocyte cells which manufacture melanin are situated at the very bottom of the skin’s epidermal layer. Sometimes the over-production of the melanin pigment could lead to various hyperpigmentation problems. Such creams aside, there are other many effective modes of treatment so it would be wise to discuss them.
i) Hydroquinone: Hydroquinone is the main component for stoppage of melanin production. The ingredients of hydroquinone have strong antioxidant properties and it is a strong inhibitor of melanin production. Topical hydroquinone comes in 2% available in cosmetics, often as monobenzone, to 4% or greater concentrations available from a physician or by prescription, alone or in combination with tretinoin 0.05% to 0.1%. Hydroquinone and tretinoin prevent sun- or hormone-induced melasma. Hydroquinone is a potent inhibitor of melanin production; it prevents dark skin from making the substance responsible for skin color. Hydroquinone does not bleach the skin but it lightens it and can only disrupt the synthesis and production of melanin hyperpigmentation. It has been banned in some European countries, for example France, because of fears of a cancer risk. However, other European countries, such as Spain, have both prescription and nonprescription formulations. The European Union banned it from cosmetics in 2001, but it is found in bootleg creams in the developing world. It is sold in the United States as an over-the-counter drug with the concentration of hydroquinone not exceeding two percent. Resorcinol, or m-hydroquinone, is often used in skin-lightening cosmetics in countries where free hydroquinone is prohibited.
ii) Glutathione: Glutathione is a tripeptide molecule found in mammalian bodies. It is an antioxidant that plays an important role in preventing oxidative damage to the skin. In addition to its many recognized biological functions, glutathione has also been associated with skin lightening ability. While skin whitening reduces melanin, which serves as the natural protection from UV exposure, glutathione’s antioxidant property also protects the skin from UV radiation. Glutathione for skin whitening is available in cream, soap, lotion, nasal spray, and injectable form, however, glutathione that is applied on the skin in the form of lotion is not efficiently absorbed by the skin cells. On the contrary, intravenous glutathione delivers very high doses directly into the systemic circulation and is the preferred mode of administering glutathione. However, this method of administrating the antioxidant might flood the cells with glutathione, which may cause reductive stress. Glutathione can be combined with many other agents like Vitamin C to increase its absorption, N-acetyl cysteine to boost its levels, and other antioxidants like Vitamin E.
iii) Bleaching: This skin whitening treatment involves application of bleach frequently which whitens the skin color. The bleaching effect is not permanent as it remains only for a short duration. Hence, bleaching comes under cosmetic solutions and does not give a natural look or a permanent solution.
iv) Laser Surgeries: During laser surgery skin lightening treatment, ablative and non-ablative lasers are used. They stimulate collagen production by affecting the melasma drastically which lightens the skin. However, the results are not always consistent, and problems have been reported, such as hypopigmentation or hyperpigmentation. Laser treatments of this kind are more likely to result in problems for those with darker skin tones.
v) Chemical Peels: Chemical peels skin whitening and lightening treatment involves tretinoin based peels. They lead to faster skin maturity, making it easier to peel off older and darker skin. As new layer of skin comes up, desired skin lightening is achieved. Users of tretinoin have to avoid sunlight, as the skin can tan and tretinoin also makes the skin more sensitive to UVA and UVB rays.
vi) Cryosurgery: This skin treatment is best for irregular skin darkening and dark spots. Targeted application of liquid nitrogen for freezing skin lesions results in destruction of darker skin cells and their replacement with lighter and new cells. Controlled destruction of skin cells causes the skin to naturally regenerate itself. Excess melanin comes to the surface and peels off in a few days. This is particularly useful in sensitive areas like the genitals where laser treatment could leave a scar. Efficacy of the treatment depends on the depth of the pigment.
vii) Microdermabrasion: Microdermabrasion is a light cosmetic procedure that uses a mechanical medium for exfoliation to remove the outermost layer of dead skin cells from the epidermis. Most commonly, microdermabrasion uses two parts: an exfoliating material like crystals or diamond flakes and a machine-based suction to gently lift up the skin during exfoliation. It is a non-invasive procedure and may be performed in-office by a trained skin care professional. It may also be performed at home using a variety of products which are designed to mechanically exfoliate the skin. Many salon machines and home-use machines use adjustable suction to improve the efficacy of the abrasion tool. Microdermabrasion is considered a relatively simple, easy, painless, non-invasive skin rejuvenation procedure as it involves no needles or anesthetics.
However, there are certain drawbacks associated with such treatments as well. here is evidence to suggest that some types of skin-whitening products use active ingredients, such as mercurous chloride and hydroquinone, which can be very detrimental. Hydroquinone is not available without a prescription in Europe. This is also the case with many other countries where hydroquinone can only be prescribed by a doctor for certain skin conditions. A test of common skin lightening creams available in Nigeria showed that they caused mutations in bacteria and were possibly carcinogenic. A study that examined skin whitening creams in Mexico found a high concentration of mercury in several of them. Moreover, other potential side-effects include bruising, skin dryness, sensitivity to sunlight, tightness, swelling, scarring, skin infections, skin texture difference, pigmentation, skin redness and irritation. Deep chemical peel treatments can cause permanent damage such as hyperpigmentation (skin darkening) or hypopigmentation (skin lightening). if you undergo very aggressive treatments to whiten your skin it may become raw and ooze forming crusts all over. This shows that one has to be very careful before choosing a skin lightening product, otherwise, there can be many unwanted repercussions similar to the ones stated above and even more depending on the products that are used.
Mostly, these procedures are very low-risk and the recovery time is not very bothersome. But even then, one needs to take time out for a proper recovery plan. Laser treatments and chemical peels take a few weeks of rest while permanent skin whitening surgery takes more time. After the treatment, one needs to take care of their skin by using certain maintenance products. Sunscreen is one such very important product to aid in the prevention of unwanted skin tanning and sun burns.
In a country like Pakistan, most of these treatments are readily available in the major metropolitan cities like Lahore, Islamabad and Karachi and for lucrative rates as well. The more popular of the treatments are the glutathione injections as they are very reliable in terms of results and are also relatively safe and risk-free. The injections can cost anywhere from Rs. 5000 to Rs 20,000 here while the surgical procedures such as laser lightening surgery and cryosurgery will be even more merciless on your savings. Keeping the cost factor in mind, one can navigate their way around all the different options available and go for the most convenient one.