Complications of chronic use of skin lightening cosmetics

Dermatology Unit, Department of Medicine, College of Medicine, Lagos, Nigeria.
International journal of dermatology (Impact Factor: 1.31). 05/2008; 47(4):344-53. DOI: 10.1111/j.1365-4632.2008.02719.x
Source: PubMed


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.

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    • "Hydroquinone (HQ) has been widely used in various industries including the manufacturing of rubber, paints, varnishes, motor fuels, oils, and as a reagent in photographic developers and in cosmetic products (McGregor 2007). In addition to industrial sources, HQ exists in free form and as β-D-glucopyranoside conjugate (arbutin) in some bacteria, plants, coffee, red wine, and wheat cereals (Deisinger et al. 1996) as well as in cosmetics (Olumide et al. 2008). HQ is also one of the major components found in cigarette smoke (Gopalakrishna et al. 1994). "
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    ABSTRACT: Hydroquinone (HQ) is found in natural and anthropogenic sources including food, cosmetics, cigarette smoke, and industrial products. In addition to ingestion and dermal absorption, human exposure to HQ may also occur by inhaling cigarette smoke or polluted air. The adverse effects of HQ on respiratory systems have been studied, but genotoxicity HQ on human lung cells is unclear. The aim of this study was to investigate the cytotoxicity and genotoxicity of HQ in human lung alveolar epithelial cells (A549). We found that HQ induced a dose response in cell growth inhibition and DNA damage which was associated with an increase in oxidative stress. Cytotoxicity results demonstrated that HQ was most toxic after 24 h (LC50 = 33 μM) and less toxic after 1 h exposure (LC50 = 59 μM). Genotoxicity of HQ was measured using the Comet assay, H2AX phosphorylation, and chromosome aberration formation. Results from the comet assay revealed that DNA damage was highest during the earlier hours of exposure (1 and 6 h) and thereafter was reduced. A similar pattern was observed for H2AX phosphorylation suggesting that damage DNA may be repaired in later exposure hours. An increase in chromosomal aberration corresponded with maximal DNA damage which further confirmed the genotoxic effects of HQ. To investigate whether oxidative stress was involved in the cytotoxic and genotoxic effects of HQ, cellular glutathione and 8-Oxo-deoguanisone (8-Oxo-dG) formation were measured. A decrease in the reduced glutathione (GSH) and an increase oxidized glutathione (GSSG) was observed during the early hours of exposure which corresponded with elevated 8-Oxo-dG adducts. Together these results demonstrate that HQ exerts its cytotoxic and genotoxic effects in A549 lung cells, probably through DNA damage via oxidative stress.
    Full-text · Article · Jun 2013 · Cell Biology and Toxicology
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    • "The experience of Coffee corroborates the findings by Sanders (2008) that the commercial relationship between female sex workers and their male clients reflects the values and norms of the non-commercial relationships in society. The complexion consensus also colors the experience of sex workers in Africa and Asia where the light skinned ones are perceived as more sexually attractive and get more clients and so many sex workers bleach their skin (Canotal 2009; Oluminde et al. 2008). "
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    ABSTRACT: This article focuses on the sexual attraction motive for skin bleaching in Jamaica. Some captive Africans on plantations in Jamaica altered their complexion. These Africans modeled the British in the colony who bleached their skin to protect the “superior,” “sexy,” and ideal white skin from the “impurities” of interracial sex and the tropical climate. The beauty and sexual attraction accorded to light skin was also evident in skin bleaching newspaper ads in the 1950s. The ads told women that acquiring light complexion through skin bleaching would make them sexually attractive to men. The persistence of colorism and its most blatant expression—skin bleaching—is also evident in contemporary Jamaica as expressed in some dancehall songs which praise skin bleachers, and the explanatory narratives of skin bleachers that bleaching makes them pretty and sexually attractive to potential spouses. Similar themes are reflected in the criticism that the browning Dancehall Queen Carlene was deemed sexually attractive and choreographically talented only because of her brown physicality. Some spouses request that their partner acquire the bleached physicality because they find it sexually attractive similar to many male clients in “massage parlors” who only request female sex workers who bleach their skin.
    Full-text · Article · Dec 2011 · Sexuality & Culture
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    • "En revanche, plusieurs observations ont montré des intoxications avec syndrome néphrotique par passage transdermique lors de l'application cutanée de crème ou savon éclaircissant contenant des sels de mercure inorganique [14] [15]. Encore récemment, elles sont décrites dans des pays en voie de développement et dans certains pays industrialisés qui n'ont pas légiféré pour en interdire l'utilisation dans les produits cosmétiques [16] [17] [18]. Le taux d'absorption digestive des dérivés inorganiques, tels que le chlorure mercurique, suite à l'ingestion volontaire ou accidentelle peut aller jusqu'à 10 % et peut être à l'origine d'une intoxication aiguë [2]. "
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    ABSTRACT: Mercury is a widespread heavy metal with potential severe impacts on human health. Exposure conditions to mercury and profile of toxicity among humans depend on the chemical forms of the mercury: elemental or metallic mercury, inorganic or organic mercury compounds. This article aims to reviewing and synthesizing the main knowledge of the mercury toxicity and its organic compounds that clinicians should know. Acute inhalation of metallic or inorganic mercury vapours mainly induces pulmonary diseases, whereas chronic inhalation rather induces neurological or renal disorders (encephalopathy and interstitial or glomerular nephritis). Methylmercury poisonings from intoxicated food occurred among some populations resulting in neurological disorders and developmental troubles for children exposed in utero. Treatment using chelating agents is recommended in case of symptomatic acute mercury intoxication; sometimes it improves the clinical effects of chronic mercury poisoning. Although it is currently rare to encounter situations of severe intoxication, efforts remain necessary to decrease the mercury concentration in the environment and to reduce risk on human health due to low level exposure (dental amalgam, fish contamination by organic mercury compounds…). In case of occupational exposure to mercury and its compounds, some disorders could be compensated in France. Clinicians should work with toxicologists for the diagnosis and treatment of mercury intoxication.
    Preview · Article · Jul 2011 · La Revue de Médecine Interne
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