Vitamin A Skin Cream

The term skin whitening (also called skin bleaching ) covers a variety of cosmetic methods used in an attempt to whiten the skin.

Skin lightening or whitening is a controversial topic as it is closely intertwined with the detrimental effects on health, identity, self image, racial supremacy and colonial mentality. There is evidence to suggest that some types of skin-whitening products use active ingredients (such as mercurous chloride) which can be harmful.

Uses

Specific zones of abnormally high pigmentation such as moles and birthmarks may be depigmented to match to the surrounding skin. Conversely, in cases of vitiligo, unaffected skin may be lightened to achieve a more uniform appearance. However, in cases where these spot treatment creams are used in attempt to lighten the entire complexion, all of the current methods are considered ineffective. Complete skin depigmentation is simply a futile process. An additional application is genital or anal bleaching, intended to reduce the typically darker pigmentation of the genital and perianal area.

History

In Japan, geisha were (and still are) known for their painted white skin, which represents beauty, grace, and high social status. However, the skin-whitening products are not used in such a wide scale in Japan today. Geisha paint their skin white in geisha-based ceremonies to celebrate their culture and background.

Today, skin whitening products are available in the form of creams, pills, soaps or lotions. The mechanism of permanent whitening is usually by the breakdown of melanin by enzymes, such as that contained in the droppings of the Japanese bush warbler or reducing agents such as hydroquinone. Most whitening creams also contain a UV block to prevent sun damage to the skin.

Skin whitening creams (fairness creams) are used extensively in India and among the Indian diaspora abroad. In India, these creams are marketed towards all groups from rural villagers to urban professionals. The creams are also sold throughout the rest of Asia, Africa, Latin America and the Middle East. The whitening cream industry is estimated to be worth around $432 million in India and $7 billion in China. Due to the increasing trend of targeting male consumers and endorsements by celebrities such as Indian actor Shahrukh Khan, sales have increased at a rate of 14% in non-European markets in only the last year.

Further information: History of cosmetics

Melanin and pigmentation

Uneven pigmentation affects most people, regardless of ethnic background or skin color. Skin may either appear lighter or darker than normal; there may be blotchy, uneven areas, patches of brown to gray discoloration or freckling. Skin pigmentation disorders occur because the body produces either too much or too little melanin. Melanin is the pigment produced by melanocyte cells. It is triggered by an enzyme called tyrosinase, which creates the color of skin, eyes, and hair shades.

Melanin has two major forms that combine to create varying skin tones. Eumelanin produces a range of brown skin and hair color, while pheomelanin imparts a yellow to reddish hue.

Melanin provides some amount of sun protection for the skin by absorbing ultraviolet light. Darker skin colors are less susceptible to sunburn and the overall effects of sun damage.

Increased melanin production — also known as hyperpigmentation — is often referred to as melasma, chloasma or solar lentigenes.

Melasma is a general term describing darkening of the skin.
Chloasma is generally used to describe skin discolorations caused by hormones. These hormonal changes are usually the result of pregnancy, birth control pills or estrogen replacement therapy.
Solar lentigenes is the technical term for darkened spots on the skin caused by the sun. Solar refers to sunlight and lentigene describes a darkened area of skin. These spots are quite common in adults with a long history of unprotected sun exposure.

Aside from sun exposure and hormones, hyperpigmentation can be caused by skin damage, such as remnants of blemishes, wounds or rashes. This is especially true for those with darker skin tones.

The most typical cause of darkened areas of skin, brown spots or areas of discoloration is unprotected sun exposure. Once incorrectly referred to as liver spots, these pigment problems are not connected with the liver.

On lighter to medium skin tones, solar lentigenes emerge as small- to medium-sized brown patches of freckling that can grow and accumulate over time on areas of the body that receive the most unprotected sun exposure, such as the back of the hands, forearms, chest, and face. For those with darker skin colors, these discolorations can appear as patches or areas of ashen-gray skin.

Combination treatments

Most skin-lightening treatments, which can reduce or block some amount of melanin production, are aimed at inhibiting tyrosinase. Many treatments use a combination of topical lotions or gels containing melanin-inhibiting ingredients along with a sunscreen, and a prescription retinoid. Depending on how the skin responds to these treatments, exfoliants — either in the form of topical cosmetic or chemical peels — and lasers may be used. New development using LED systems are showing good results also

Topical treatments

Topical hydroquinone is considered by many dermatologists to be a safer, similarly effective (if not more so), and less expensive option than lasers or deep peel treatments. Topical hydroquinone comes in 2% (available in cosmetics) to 4% (or more) concentrations (available from a physician or by prescription), alone or in combination with tretinoin 0.05% to 0.1%. Research has shown hydroquinone and tretinoin to be powerful tools against sun- or hormone-induced melasma.

Hydroquinone has been shown to cause leukemia in mice and other animals. The European Union banned it from cosmetics in 2001, but it shows up in bootleg creams in the developing world. It is sold in the United States as an over-the-counter drug, but with a concentration of hydroquinone not exceeding 2 percent.

Some research has shown topical azelaic acid in 15% to 20% concentrations to be as efficacious as hydroquinone with a decreased risk of irritation. Tretinoin by itself has also been shown to be useful in treating hyperpigmentation of sun-damaged skin. Kojic acid, alone or in combination with glycolic acid or hydroquinone, also has shown good results due to its inhibitory action on tyrosinase (though kojic acid has had problems in terms of stability and potential negative effects on the skin and is rarely used today). Several plant extracts and vitamin C also have some research showing them to be effective for inhibiting melanin production.

Niacinamide is claimed to be a much safer alternative when applied topically for skin or genitalia whitening. According to a cosmetic company, it has no adverse side-effects and as well as acne reduction, also increases skin moisture and reduces fine wrinkles.

Mercury

Many skin whiteners contain toxic mercury such as mercury(II) chloride or ammoniated mercury as the active ingredient.

Hydroquinone

In medical literature, hydroquinone is considered the primary topical ingredient for inhibiting melanin production. Its components have potent antioxidant abilities.

Hydroquinone is a strong inhibitor of melanin production, meaning that it prevents skin from making the substance responsible for skin color. Hydroquinone does not bleach the skin but lighten, and can only disrupt the synthesis and production of melanin hyperpigmentation. It has been banned in some countries (e.g. France) because of fears of a cancer risk.

Some concerns about hydroquinone's safety on skin have been expressed, but the research when it comes to topical application indicates negative reactions are minor or a result of using extremely high concentrations or from other skin-lightening agents such as glucocorticoids or mercury iodine. This is particularly true in Africa where adulterated skin lightening products are commonplace.

Because of hydroquinone's action on the skin, it can be irritant, particularly in higher concentrations of 4% or greater and predictably when combined with tretinoin. Some medications have been created that combine 4% hydroquinone with tretinoin and a form of cortisone. The cortisone is included as an anti-inflammatory. The negative side effect of repeated application of cortisone is countered by the positive effect of the tretinoin so that it does not cause thinning of skin and damage to collagen.

Hydroquinone can be an unstable ingredient in cosmetic formulations. When exposed to air or sunlight it can turn a strange shade of brown. Therefore, when you are considering a hydroquinone product, it must be packaged in a non-transparent container that minimizes light and air exposure. Hydroquinone products packaged in jars are not recommended because they become ineffective shortly after opening.

Alternatives to hydroquinone

Some of alternative lighteners are derivatives of hydroquinone. They include Mitracarpus scaber extract, Uva ursi (bearberry) extract, Morus bombycis (mulberry), Morus alba (white mulberry), and Broussonetia papyrifera (paper mulberry). All of these contain arbutin (technically known as hydroquinone-beta-D-glucoside), which can inhibit melanin production. Pure forms of arbutin are considered more potent for affecting skin lightening (alpha-arbutin, beta-arbutin, and deoxy-arbutin).

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