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February - March 2006


Health

The Complexity of Complexion

by Sujata Jolly


“They say God made humans in His image,
and humans have been trying to repair the
handiwork ever since”
Oscar Wilde

Would you use a cream or soap that may have the following long term side effects … skin cancer, liver damage, kidney damage or poisoning? Sujata Jolly, a graduate in medical sciences, highlights the dangers of skin bleaching products.

In the modern appearance conscious society, there is a myth that lighter paler complexions portray beauty, riches and success. A fair complexion remains de rigueur particularly in Asian and African cultures. Unscrupulous traders continue to meet the substantial demand for skin bleaching products although most are prohibited for sale in the United Kingdom.

On 27th July 2005, a batch of more than 46,000 tubes labelled body cream was intercepted at Gatwick airport in a container from Lagos, Nigeria. These creams contained steroids and were en route to a warehouse in London for distribution. Soon after, customs made their largest seizure of a consignment of creams containing hydroquinone from West Africa. We will never know what amount of such products gets through the net to be sold under the counter.

My first reaction was here “we go again”. Hardly a week passes without a mention of the damaging effects of skin bleaching in the media. Many journalists and television researchers are in touch with me due to my very long association with the campaign that culminated in the ban of hydroquinone in cosmetics. Some of us turn a blind eye to the warnings and just sleep walk into a situation that has loud and clear warnings of turning into nightmare.

Obsession With Lightening Skin Colour
Skin lightening preparations are used by many people of Asian and African origin to lighten their skin in response to social pressures or perhaps for psychological reasons. They are the victims of old colour myths, where we are led to believe that a paler complexion is more virtuous. Indeed the media has made fair complexions a marketable commodity as is amply illustrated by the matrimonial columns in the Indian press.

Many Asian women believe they can attract wealthier and more desirable husbands if they have lighter skin. India has seen a phenomenal growth in the sale of skin lightening creams, currently valued at over $190m indicating a huge obsession with fair skin. This hit the headlines as a row over a recent television advertisement for skin lightening cream fuelled a heated debate in India over why fairer skin should be considered more beautiful and be a measure of success.

Women’s groups in India considered this promotion demeaning to women portraying them as items of lust. Woman-power worked and the advertisement was taken off the air. Ironically the health implications of using skin bleaching creams were not debated. Getting the advertisement banned was a hollow victory; as such products remain openly available for sale.

I also find it rather disturbing that Dr Jamuna Pai is freely dishing out her expert advice to the Shaddi.com readers to use Hydroquinone/ Kojic Acid/ and Vitamin C to lighten their skin.

Although, as a minor mitigation, she does add “also cover the areas with a good sun block during the day, as the skin-lightening agents tend to make the skin sensitive to the sun.” Why on earth bleach first to inhibit the production of melanin by destroying the melanin producing cells and then use another chemical to protect the skin against sun rays. Asian and African skins are naturally blessed with enough natural sun protection for a normal every day lifestyle so I believe there is no need for any additional intervention. Only cases where there is excessive and prolonged exposure to the sun warrant additional protection.

Skin Colour
There is a wide geographical distribution of skin colour related to the solar intensity experienced by the inhabitants of the various regions. People tend to be darker in tropical regions and fairer in more temperate zones. However, in Arctic regions the skin is somewhat on the dark side again due to snow glare; this is borne out by the Inuits in particular.

The colour of one’s skin is due to a biological pigment called melanin. Both genetic and environmental factors determine the amount of melanin in the skin. Melanin is produced by cells called melanocytes and a partial destruction of melanocytes will reduce melanin levels leading to a fairer complexion. This is a simple, albeit a little flawed, explanation of a technically complex subject.

Melanin plays a crucial role in the absorption of free radicals and it also shields the skin from immediate damage of solar radiation protecting the skin against sunburn. Melanin can be regarded as a key to human survival. Nature created this biological mechanism for our protection and we should not destroy it for some false promises

Campaign Against Bleaching Creams

I graduated in medical sciences and later specialised in aetiology and then dermatology including formulating innovative products. In 1979, as a young scientist and a mother, I set up my own research and development consultancy to treat skin disorders.
I was overjoyed when a Ugandan marketing company approached me in 1983 with a proposal for me to develop and supply a high strength skin bleaching range for the multi-million dollar African market.

However, my euphoria was transient. Within weeks I realised the potentially harmful effects these products might have on skin. I decided that this was one project I would not touch with a barge pole. This chance episode jolted my conscience and became the starting point for me to lead a long and arduous campaign against the use of skin lightening creams. I also pledged to concentrate on developing treatments that could help to reverse and to treat the damage caused by such products.

Hydroquinone – Traditional Bleaching Agent
The use of hydroquinone in cosmetics for over the counter sales is not permitted in European Union due to its adverse biological reactions. In the early part of the 20th century, workers in a rubber manufacturing plant observed de-pigmentation of their skin leading to white patches. This was attributed to the use of hydroquinone as an anti-oxidant in the manufacturing processes. The workers sued for damages as a result of their injuries, but at the same time this ‘discovery’ led to the commercial exploitation of hydroquinone as a skin-bleaching agent in cosmetic creams to meet the Asian and African desire for a paler complexion.

Destruction of Natural Protection
Hydroquinone was initially understood to inhibit the production of melanin, but later studies demonstrated that it in fact destroys melanocytes. This means that hydroquinone based products would undoubtedly lighten the skin but at a price. The price, as I will explain below, is frightening, and it is not worth taking the risk to look like the Joneses.

As melanocytes from the skin are gradually destroyed by the use of bleaching creams, the skin is left at the mercy of harmful ultra-violet rays rendering it defenceless and fragile. It is a known fact that the dark skinned persons rarely suffer skin cancer but that valuable protection is lost with the partial destruction of melanocytes. Wounds on bleached skin take long to heal. Any surgical wounds may not be able to hold sutures because of deterioration of the epidermis.

Hydroquinone is known to cause skin irritation, post inflammatory hyper-pigmentation and nail discolouration. Upon exposure to sunlight, the skin can develop ochronosis - a chronic condition characterised by a sooty black coarse appearance. However, after prolonged use, hydroquinone can penetrate into the lower layers of the skin causing thickening of the collagen fibres. This may be the start of irreversible damage to the connective tissue in the skin and cartilage. It is insanity to risk paying such a price for temporary lightening of the skin.

A final nail in the coffin for hydroquinone are more recent studies suggesting it to be mutagenic (capable of causing changes in the genetic material).

Proscription of Hydroquinone in Cosmetics
For over 20 years I have vigorously campaigned to have the key ingredients used in the skin bleaching products banned and also to create public awareness of the dangers associated with using such products. I did this by writing features for the popular and professional press and by appearances on the radio and television. I was helped by some like-minded scientists and trading standard officers who offered me valuable guidance that helped build momentum for this campaign.
The dangers of skin bleaching creams were considered serious enough and repeated representations to health ministers finally brought good news. The use of hydroquinone was banned in January 2001 for over the counter cosmetics within the EU. Now it is only permitted in the prescription products under medical supervision.

Beware of Second Generation Bleaching Agents
Hydroquinone in developed countries was recently replaced by a new wonder ingredient Kojic Acid discovered by Japanese scientists. The honeymoon did not last very long. Animal testing has shown that Kojic Acid can cause embryo toxicity, systemic toxicity in the liver and kidneys, and cancer of the liver. As a result Kojic Acid has already been banned as a cosmetic ingredient in Japan in 2003, soon followed by Korea and Switzerland, because of the potential mutagenicity concerns.

I am already aware of the increasing difficulties obtaining Kojic Acid through the normal supply chain from Japan. It seems that it is only a matter of time before the use of Kojic Acid as a cosmetic ingredient is banned in the EU.

Remember colour is only a pigment of your imagination……

A graduate in medical sciences, Sujata worked for 14 years as a research and development scientist for leading blue chip companies. In 1979 she founded her own company Depeche Mode Laboratories where intense research is being done to develop remedies for skin problems. She introduced the ancient Eastern art of micro-pigmentation to the UK. She is often invited to lecture upon skin and skin-related problems by various medical institution in the UK and abroad.

More Health

More articles by Sujata Jolly

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