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"How do skin lighteners work and are they safe?"
I'm Indian, and have family members in India that are talking about skin lightening, which is more popular among women there. Is this practice safe?
You are asking a very timely question about a practice that is becoming more and more common. The most disturbing part of your question is the fact that skin color continues to be seen as a factor in the perception of beauty, with the implied or stated belief that lighter skin is better. A recent (2010, available online) review article in the British Medical Journal by Dr Yetunde Olumide reviews some of the common beliefs that inspire the use of skin lightening products, which are increasingly popular in various parts of the world.
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There are many products that are available for the purpose of lightening skin. Some of these work by decreasing the amount of pigment that the body makes naturally, and others claim to actually bleach the skin. In the US, these products are regulated to some degree by the Food and Drug Administration (FDA), but the same cannot be said for products obtained in other parts of the world. As Dr Olumide's article points out, these products can contain toxins such as mercury or potent steroids that can cause serious long term adverse effects. These effects can be especially significant because of the large body surface that is involved. In short, when any chemical is used in large concentrations for long periods of time, there will be effects. Please advise your family members to discontinue the use of these products, which will help with their health and also discourage the erroneous belief that skin color affects beauty. If they persist in their beliefs and desires, please ask them to seek medical counsel to appropriately choose products with the fewest side effects.
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