Last Updated on 7th February 2022 by Caroline Haye
Changing your skin colour: reasons and risks
What are skin-whitening (a.k.a. skin-lightening or skin-bleaching) treatments? Quite simply, they are products or procedures that lighten the colour of skin. The clue, of course, is in the name. But don’t be fooled into thinking that something with such a self-explanatory description always does what it says on the tin. Results vary and cannot be guaranteed. In fact, they can be devastating. So, if you are considering skin-whitening treatments for vitiligo, or for any other reason, please read on.
Permanent skin-whitening agents (as opposed to camouflage or make-up) work by reducing the concentration of melanin present in the skin…Which is a pretty serious thing to do… One which is unpredictable and usually irreversible. The products and procedures available come in a variety of strengths and formulations. (Some on prescription only, others over the counter.) And they are big business around the world. Why? Well, there are various medical and cosmetic reasons why a person might want to use them… Including “camouflaging” vitiligo. But the bottom line is that you should think carefully about your particular reasons beforehand. And, you should definitely take qualified medical advice before trying any medicated cream or medical-grade procedure.
Methods of skin-lightening
Some skin blemishes, like birth marks, can be successfully lightened with laser therapy. Clinical de-pigmentation for vitiligo, on the other hand, (which doctors rarely recommend) involves chemical medications. The treatment usually requires regular applications of a hydroquinone-based agent, which is only available on prescription.
Over-the-counter skin-whitening products containing hydroquinone, corticosteroids or mercury are illegal in the UK because of their potential health risks. But, unfortunately, there are no such restrictions in many other countries worldwide.
In addition to these, there are numerous other beauty products on the market that claim to lighten the complexion using safer ingredients. But most simply help to reduce sun damage rather than actually making any significant change to your skin colour.
Reasons for using skin-lightening treatments
The reasons a person might choose to lighten their skin fall into two main categories. The first would be to correct or camouflage a blemish or discoloration (e.g. a birth mark, vitiligo or melasma). And the other might be in response to cultural or fashion-related influences. Individual reasons vary. But they probably all have the same ultimate goal: to help the individual feel happier in their own skin. In other words, to increase self-confidence.
“Good” versus “bad” reasons
It is not for me (or anyone else) to say whether another person’s motivation to alter their appearance is justified or not. It’s a personal decision that they should make for their own reasons. But, in all honesty, I do think that there are such things as good reasons and bad reasons.
In my book, making a good decision for the right reasons involves two important processes. Firstly, listening to what your own inner self is telling you will genuinely make you happy (without any undue external pressures). And secondly, making sure that the treatment you are considering is likely to be safe and effective.
Trying to conform to the expectations of others, on the other hand, would be a bad reason… As would rushing into a treatment in a fit of enthusiasm, without checking it out fully first. In other words, the decision to undergo a cosmetic procedure (which skin-whitening is, even if it is only a cream) is not one to make lightly (no pun intended).
But before we get into the pros and cons of skin-bleaching treatments more specifically, here are a few thoughts for you to ponder on the wider subject of manipulating one’s natural colouring.
Changing your colour
It’s generally only when something goes wrong with our skin that we start to appreciate how amazing this stuff is that each of us is wrapped in. If you need any convincing of how miraculous human skin is, just take a look at 6 Reasons Not To Hate Your Vitiligo Skin.
Leaving aside the question of skin diseases for a moment, have you ever stopped to consider how beautiful and miraculous human skin is, in all its variation of shades and types? And have you ever thought about the absurdity of wanting to change it?
Why do millions of white people feel the need to bake their body in direct sunshine for hours on end to get a tan? And why do so many people of colour expose their beautifully-pigmented skin to dangerous chemicals on a daily basis in an attempt to go lighter?
It’s a crazy world where some of us risk cancer and premature wrinkles, in an excess of sunbathing, trying to go darker… While others are willing to risk toxic damage and uncertain results in an attempt to do the opposite. It makes very little sense to me.
Achieving a uniform colour
Trying to achieve a uniform skin colour in cases of vitiligo or other pigmentary disorders is another matter though. Just as my goal was to return my white patches to their original colour, some people view the problem from the other end. They try to bleach what’s left of their normal colour to match their vitiligo skin. Neither process comes with any guarantees. But, in my mind at least, a decision to re-pigment was a positive attempt to recover and achieve better health… Whereas a decision to de-pigment would have felt like “giving in” to the disease process happening in my skin. In fact, it would have felt like giving this process a helping hand. And, worse still, what about the risks involved in deliberately removing pigment from your skin?
Risks for using skin-lightening treatments
The possible side-effects of the powerful medications used for vitiligo de-pigmentation are unpleasant and even dangerous. They include irritation, thinning of the skin, scarring and infection, as well as liver, kidney or nerve damage. And, surprisingly, they can even cause darkening of the skin and uneven pigmentation… Which would clearly defeat the whole object. Not just that, but there is no guarantee that any of these side-effects would not be permanent.
Another factor to take into account is that the results you achieve may not match your expectations. For a start, the process may not result in the total de-pigmentation of your skin. So you could find you still have patches of normal skin colour instead of the even complexion you were aiming for. And you will probably also lose some or all of the pigment in your hair, brows and eyelashes too. So, if you are expecting to look anything like the picture below, you are probably in for a disappointment.
Even under medical supervision, skin-whitening carries these dangers. But using products purchased on the internet and without a prescription is even riskier because they may contain illegal ingredients. (Unfortunately, the skin-lightening market has attracted some unscrupulous traders, as this article in the Guardian describes.) Even if the ingredients on the packaging don’t include banned substances, there is no way of knowing if the contents listings are even accurate or truthful. And, of course, there is no way to ensure you will use the product correctly either.
Skin bleaching for vitiligo
I am not saying that all skin-lightening treatments are a bad idea. Using a lightening product or procedure under expert supervision may be a helpful option for anyone whose birth mark or melasma is causing them distress. And, for some people with widespread vitiligo, it can offer at least the possibility of achieving a more even skin colour. But the option is very much a last resort, rather than a routine therapy.
The suitability of skin-bleaching for vitiligo depends on how much of your natural colour you have already lost. Choosing to completely de-pigment (which is what skin-bleaching aims for) would probably not be appropriate in cases of less than 50% vitiligo. In fact, as someone who had 80% vitiligo before subsequently re-gaining nearly all my lost pigment, I am very glad that I never opted for chemical de-pigmentation… Especially as the process is usually irreversible, with some exceptions (see Can Vitiligo Depigmentation Therapy Be Reversed?)
Skin bleaching for cultural reasons
It is difficult to write about the cultural pressures for skin-whitening that exist in some societies without sounding judgemental. But I honestly cannot think of any justifiable reason for these to persist in the twenty-first century. The notion of paler skin as more desirable or a sign of social standing is abhorrent. And yet it is endemic in some cultures, meaning that skin-bleaching products are among the top-selling cosmetics… The majority of these in countries where the active ingredients are unregulated. And, to make matters worse, there is no shortage of celebrities who perpetuate the problem by lightening their own skin. (See the section on “colourism” in this BBC article.)
A couple of months ago I came across an example of the needless anguish that such cultural pressures can cause. A young woman of south Asian heritage contacted me to say that she had developed chemical leucoderma (i.e. chemically induced vitiligo) as a result of using a skin-lightening cream containing hydroquinone. Unfortunately, she had also recommended the cream, which she had ordered online from China, to her mother. And her mother too had begun to develop vitiligo as a result. Understandably, both women were distraught. A product they had believed would enhance the appearance of their skin had induced a distressing pigmentary disorder that may well prove permanent.
My conclusions
After immersing myself in this topic for the past few weeks, I have emerged feeling deeply uncomfortable with the whole idea of skin-whitening. I find it hard to think of any really valid reason for it, except in certain very specific medical contexts, and then only as a last resort. My main reasons for coming to this conclusion are:
- the risk of triggering chemical vitiligo
- additional risks of other unwanted or dangerous side effects
- and the perpetuation of colourism.
But, more than that, all my instincts tell me that our skin, whatever colour it is, is a precious gift to be nurtured and protected. Chemically manipulating its natural pigmentation strikes me as inherently destructive, irreverent in fact. And, even in its medical context, the notion of “killing off” healthy pigment cells as a form of “therapy” seems like a pretty major contradiction in terms.
