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Fair skin at your own risk

Tuesday, September 18, 2018

Beware of medical spas and quacks offering ‘skin whitening’, where patients are promised fairness and hooked up to unapproved treatments to make money out of public obsession, warns Dr. Rinky Kapoor

In India, and most Asian countries, a ‘fair complexion’ has been equated with ‘beautiful’ for generations. People come to the dermatologist’s clinic asking for ‘skin lightening’. It has, in fact, become an obsession, especially after some misleading media information on celebrities doing such treatments involving injections hailed as miracle fairness potions.

Traditionally, in clinical practice, skin lightening treatments are done for patients who have genuine pigmentation problems like melasma, sun induced pigmentation and birthmarks. It involves tablets, creams, lasers/peels or a combination of these. But now, it seems to have taken a different meaning altogether.

Where the story of injections for lightening started from was that patients suffering from liver failure, who were injected with ‘very high’ doses of the master antioxidant glutathione and vitamin C, showed clearing of skin hyperpigmentation as a collateral benefit.

Thereafter, there have been numerous injectable combinations of antioxidants like glutathione, alpha lipoic acid, Vitamin C and so on in the market, promising skin lightening, none of them being FDA approved yet for aesthetic purposes. Some of these contain like placental extracts and animal collagen.

Though many physicians who are currently conducting trials on specific injectable  combinations are noticing positive results with some, no formal supportive study is available. Until a documented placebo-controlled study documents scientifically the results and side effects, they are being taken at the patient’s own risk.

What is the procedure?

High doses of oral antioxidants like glutathione, or alpha lipoic acid which is known to remove toxic free radicals , and improve skin health and brightness;

Vitamin C supplements to enhance the absorption of glutathione.

Creams containing proven skin lightening agents like arbutin, kojic acid, glycolic acids, retinoids, rumex occidentalis and hydroquinone.

Injections containing glutathione given intravenously. This is not yet FDA approved as a skin lightening agent. There are no guidelines mentioning in whom to use, in how much dose, or for how long. Studies are going on to figure out all of the above. Many fake products are available in the market due to extremely high demand and it is dangerous to use them without supervision. Initial treatments are done weekly for 12 to 16 sessions, thereafter tapered gradually over a few months, and may need maintenance.

NdYAG laser reduction of skin pigment requires multiple sessions to see good benefits but is expensive. Injections alone do not suffice generally and are combined with other procedures for the desired outcome.

Who should get it done?

Those with hyperpigmentation due to prolonged sun exposure, medicines, hormone disturbances, melasma, tanning of skin, post acne, or who desire improvement in skin dullness due to reasons like improper skin care taken. If done only for lightening the complexion in a dark-skinned person, it is clinically not advocated as there are no guarantees and it may require ­­lifelong maintenance.

Who should not get it done?

It is completely contraindicated in children and babies. There have been reports of parents asking for skin lightening of their newborn child! This is unethical, shameful and is strongly condemned.

Avoid in those with history of allergic reactions, malignancies, respiratory, cardiac, liver or kidney problems, pregnant and breast-feeding ladies.

Things to know before undergoing this treatment.

If it is being done for complexion lightening in an original dark skin tone, injections are not yet FDA approved and no guarantees can be made that they will benefit. Possible risks: allergic reactions, effects on the liver and kidneys, poor cosmetic outcome, prolonged maintenance, uneven distribution of colour in  the body.

Beware of medical spas and quacks offering ‘skin whitening’ where patients are promised fairness and hooked up to unapproved treatments to make money out of public obsession.

Dr. Rinky Kapoor is a Cosmetic Dermatologist and Dermato-Surgeon.

Short Takes

‘Skin lightening’ has become an obsession, especially after some misleading media information on celebrities doing such treatments involving injections hailed as miracle fairness potions.

Though many physicians who are currently conducting trials on specific injectable  combinations are noticing positive results with some, no formal supportive study is available.

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