The hidden dangers: Many users of skin-lightening products are unaware of risks

Those who rely on skin-lightening products are largely unaware of their potential harm and don't consult a doctor before trying them, according to an analysis in the International Journal of Women's Dermatology. They're also more likely to exhibit colorist attitudes - beliefs that those with lighter skin are more beautiful and socially advantaged than those with darker skin - than people who don't use such products.

Researchers from Northwestern University anonymously surveyed 455 people who said they were Black, Asian, Hispanic, Native or multiracial, and asked them about their use of skin-lightening products. The goal was to see whether colorist attitudes might influence the use of such products.

Eighty percent of the participants were women, and 21.3 percent reported using skin lighteners at some point. About 15 percent said they were first-generation immigrants and 31.2 percent identified as second-generation immigrants.

The majority of those who used skin lighteners - 73.2 percent - said they'd bought the products to manage a skin condition such as acne or hyperpigmentation. But 26.8 percent said they bought skin lighteners for general use. Only 22.6 percent of those who used skin lighteners said they'd sought information from a medical provider before use.

Researchers asked participants about their attitudes toward skin color, assigning a composite "colorism score" based on their answers. Skin-lightener users were likelier to think that lighter skin is more beautiful, increases self-esteem or boosts the chance of romantic relationships. The average skin-lightener user had a higher score than those who didn't lighten their skin.

Nearly half of the participants said they didn't know what active ingredients were in the skin-lightening products. That's of particular concern, the researchers write, because of the risks posed by skin-lightening products, many of which are unregulated and can be adulterated with toxic ingredients such as mercury.

Hydroquinone, the most commonly reported active ingredient, is associated with problems ranging from contact dermatitis to eye disease. In 2022, the Food and Drug Administration advised consumers not to use skin-lightening products that contained hydroquinone.

In a news release, Roopal Kundu, the founder and director of the Northwestern Medicine Center for Ethnic Skin and Hair and one of the study's authors, said it's important for dermatologists to understand the cultural factors behind skin lightening, even among patients who lighten their skin for medical reasons.

"Cultural mindfulness . . . allows for the safe, effective, comprehensive and compassionate treatment of dermatological disease across all communities," said Kundu, who is also a professor of dermatology and medical education at Northwestern Feinberg School of Medicine.