Dermatologist Answers 5 Common Questions on Skin Lightening

The term “skin lightening”, along with “whitening” and “fair” have often been marketed in products, particularly in Asia. Aside from being unhealthy and unsustainable, skin lightening treatments and procedures can often be dangerous. In this article, dermatologist answers 5 common questions on skin lightening, shedding light on dangerous practices, and giving tips on how to even skin tone instead of whiten it; including excerpts from Skincare Bible: Dermatologist’s Tips for Cosmeceutical Skincare by Dr. Teo Wan Lin, dermatologist at TWL Specialist Skin & Laser Centre.

Can you actually lighten your skin?

In the context of achieving a fairer skin tone, I think it is important to define if we are talking about eliminating uneven pigmentation, for example, or actually bleaching one’s skin to go to a lighter skin colour. The latter I do not recommend but in terms of making one’s skin tone more even and eliminating dark spots, there are various forms of pigmentations that you should know about including sun spots – otherwise known as solar lentigo, freckles, other medical conditions such as post inflammatory hyperpigmentation and melasma.

There are specific topical medications, lasers, as well as pills that one can use to treat these conditions. For the case of actually going to a completely lighter skin tone that is not natural for one’s genetically determined skin type, I do not recommend that and we can address that later in this chapter

What are the steps to take to achieve a fairer skin tone? Can we break it down into lifestyle, treatments and skincare?

To achieve a fairer skin tone, I will focus on how to enhance one’s skin health, so that you get less of the common hyperpigmentation conditions. We start off with genetics. Everyone is born with a certain skin type – we call that phototype. The dermatological grading of this is the Fitzpatrick phototype. For Asians, we tend to be between type III to type V. When it boils down to why people of a certain skin type, for example in phototype III, have varying amounts of skin fairness or pigmentation, it is said to be influenced by various factors.

Lifestyle certainly plays a role, as our skin contains melanin, a light-absorbing pigment molecule that also gives our skin its color. When we are exposed a lot to the sun, we activate the melanin-producing cells, melanocytes, that can cause one’s skin tone to get darker. The amount of exposure to sunlight is therefore one important factor.

Other lifestyle habits like smoking, exposure to pollution and stress for example, can lead to a process known as free radical generation in our skin and this can increase one’s risk to hyperpigmentation or risk of existing areas of pigmentation to get even darker. Unhealthy lifestyle is definitely part of factors that cause our skin to be less radiant and can also cause the skin to appear as a dull complexion with uneven skin tone.

In terms of treatment, chemical peels and lasers help to stimulate one’s skin cells, restoring it to a normal cell cycle of a young person. Overall, this causes skin to look much more radiant with an even skin tone and a fairer complexion, whilst also reducing the amount of skin surface irregularities. The lasers work by causing the skin’s natural cells to eat up areas of pigmentation – this is beneficial for those hoping to achieve more even skin tone.

Certain skincare ingredients have shown effectiveness for even skin tone. For example, retinoids (which are prescription only), and oligopeptides which is what I incorporate in my skincare as it is non-irritating with potent anti-ageing properties and stimulate one’s immune cells to eat up pigmentation and has been proven to cause lighter skin tone.

Is it realistic to maintain a lighter skin tone than you’re naturally born with?

This is a very important question as it goes back to the premise of this series. Our skin tone is genetically determined and we refer to the Fitzpatrick phototype classification as mentioned above. It is unhealthy to want to bleach one’s skin and remove one’s natural melanin which is protective. There are ways to achieve that, but it is not practised in dermatologist’s offices because it is a dangerous method. The only indication for using bleaching creams will be to lighten small areas of hyperpigmentation such as sun spots or in cases of the medical condition – melasma.

To want to lighten one’s skin entirely, it is very dangerous because it can increase your risk of skin cancer as well as accelerate skin ageing. Such treatments are reserved for medical conditions such as vitiligo whereby one has lost significant amount of skin pigmentation through an autoimmune disease and is cosmetically disfiguring. In those cases, if the body surface area is involved very significantly, it can be an indication for the dermatologist to lighten the rest of the skin as well to help the overall cosmetic appearance.

What is the fastest way to lighten my skin tone naturally?

One’s skin tone often appears dark because of uneven pigmentation that has developed over the years with ageing and sun damage, as well as having dull skin. A quick in-office treatment will be a chemical peel performed by a dermatologist, using glycolic or lactic acids in combination with a laser treatment. In my clinic, we do both as part of a skin rejuvenating treatment on the same day. The results of this is usually apparent right after treatment, especially after applying the Amino Acid Masque which contains Vitamin C and various plant extracts that helps to shrink the pores and helps in brightening the skin tone.

To shed light on them, what are some controversial skin whitening and skin lightening methods?

More than controversial, some alternative skin lightening methods can be dangerous. In particular, do be wary of cosmetic products that promise exaggerated or miraculous results, as recommended by the Health Sciences Authority with some recent high profile cases of illegal cosmetics. Such products when purchased from unfamiliar sources may be prohibited, for example due to the dangerously high levels of mercury. This toxic heavy metal is in fact prohibited as an ingredient in skincare formulations as it can cause rash, skin discolouration and blotching. Chronic exposure to mercury may also cause damage to kidneys, digestive and nervous systems.

Another controversial method would be skin lightening creams containing ingredients such as hydroquinone and retinoids (tretinoin), which which can cause serious adverse reactions. While these substances may be commonly used in a dermatologist’s office as treatment for skin conditions, the potency requires it to be prescribed only by an accredited medical professional under strict medical supervision.

Other means of skin lightening such as intravenous glutathione treatments (injection) can be unsafe. Glutathione is an antioxidant naturally found in our cells and has skin-lightening abilities by converting melanin to a lighter color and cause reduction of melanin production as a whole. As with any treatments involving direct delivery to the bloodstream, additional caution should be exercised in consultation with an accredited medical professional. While glutathione has been proven safe for oral and topical treatments, we cannot say the same when it is injected into the bloodstream, given the inadequate safety data presently. Serious skin disorders, kidney dysfunction and thyroid function impairment have been reported in some cases.

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