The fairest of them all: What you need to know about skin whitening

MANILA, Philippines – When a celebrity comes out with soft and fair skin, everyone pays attention. After all, who doesn't want to be thought of as beautiful? In a country where dark brown skin is dominant and a light skin tone is considered the holy grail of beauty, a lot of people want to achieve fair complexion. There are now many whitening products and pills, but for some who really want to go beyond what can be achieved with over the counter cosmetics and medication, they undergo a bleaching or skin peeling process.

Dr. Mylah Joven-Ching, a dermatologist from Makati Medical Center, defined the difference between whitening and skin peeling.

"Skin whitening agents work by reducing the presence of melanin in the skin. Many of them are known as competitive inhibitors of tyrosinase, the key enzyme in the production of melanin (called melanogenesis). Others inhibit the maturation of this enzyme or the transport of pigment granules (melanosomes) from melanocytes (cells that produce melanin) to surrounding keratinocytes (skin cells)."

Dr Joven-Ching said that some of the common ingredients in whitening products include: Tretinoin, hydroquinone, kojic acid, arbutin, azeleic acid, resveratrol, vitamin C, alphahydroxy acids (glycolic acid, lactic acid, mandelic acid, malic acid), salicylic acid, and niacinamide. All of these can be found in creams, lotions, and serums.

"Chemical peeling is also used to lighten the skin. This involves the application of varying concentrations of acids to slough off the upper layers of the skin where already-formed melanin resides. Trichloroacetic acid (TCA), alphahydroxy acids (AHAs), and retinoic acid are commonly used peeling solutions in dermatologist's clinics."

She also said melanin, which is substance that's responsible for the skin color has two types.

"Two types can be distinguished based on its chemical composition and biological route of synthesis: the black/brown eumelanin and the red/yellow pheomelanin. Skin color varies among individuals because of variation in the content of melanin. Skin with little or no melanin is almost white."

Dr. Joven-Ching also gave an insight about glutathinoe IV drips, which are used by many celebrities for a quick fix at their favorite derma clinics and spas. According to Dr. Joven-Ching, glutathione is an antioxidant found in many foods and aids in skin lightening.

"Glutathione is a powerful antioxidant present in all cells of the body and occuring naturally in many foods. Some studies have shown that glutathione may have the potential to fight almost any disease, particularly those associated with aging. A few small studies have suggested that it may also have the potential of lightening the skin due to its reported ability of preventing skin cells from producing melanin. This is why the beauty industry is now cashing in on this antioxidant and has offered it in oral capsule form and lately as part of an IV vitamin infusion.

"Although patients who undergo these so-called 'beauty drips' report an increase in energy and notice visible lightening of their skin, the mistake is assuming that something which feels good in the short term is consequently good for you in the long term. As of yet, there is not enough scientific evidence to suggest that IV vitamin or beauty drips are beneficial, safe, or healthy. "

 

Ideal Patients

While anyone can undergo chemical peeling or whitening, patients who are generally fairer-skinned and have light hair are good candidates, according to an article from webmd.com. Those who have dark skin can also undergo chemical peeling but the results vary.

Morie S. Vicente, who works with a real-estate company said that she took whitening pills and IV push (injection type of whitening) before her wedding. Her explanation was simple – she wanted to whiten her skin.

Morie said that she has also tried the IV drip but found it expensive. 

"Results really varies on your skin type. Thought drip was the most effective and fastest way. But as I observed, the most effective for me are the pills," she said.

Pre-op

Dr. Joven-Ching said she has seen a lot of products in the market being sold and this could be risky, and she reminds everyone to seek a doctor's approval.

"Bleaching creams, whitening procedures, glutathione capsules and IV drips are now being made available in the mainstream. I see a lot of vendors selling on Instagram and other social media platforms without thinking about the possible adverse outcomes when patients are left alone to apply these creams or peeling agents on their own. I have had many patients coming to me [because of] chemical burns [due to] unsupervised application of acids on their body. In most cases, they buy these products online or from their friends," she said. 

"In the case of whitening procedures, you get what you pay for. The price may be your health. It is best to voice out your concerns to a board-certified dermatologist the only experts in skin, hair, and nails. For a list of board-certified dermatologists all over the country please go to www.pds.org.ph."

 

Before procedure

Dr. Joven-Ching said the time it takes to see the effects of the procedures vary. In the case of skin bleaching it takes months to see some results.

"The application of bleaching preparations containing products that inhibit formation of melanin take anywhere from 1-6 months for any noticeable difference to appear," she said.

"The process of chemical peeling takes about 30 minutes to perform. They are best performed by dermatologists and plastic surgeons who have far more experience and knowledge with cosmetic procedures than other physicians. The patient's skin usually peels in 3-7 days depending on the body part treated."

 

Post procedure

When she had her IV drips for the first time, Morie said that she experienced some palpitations but maybe because she was nervous.

"As what I have observed that time, there were times during drip, siguro mga (around) twice in 10 sessions that I felt palpitations maybe because I felt nervous because of the injection. But most of the sessions naman it went okay, with no bad side effects at all," she said.

She was advised to actually continue the the drip but stopped for the meantime.

When asked if she felt anything since some of the drips were advertised as with vitamins and all, she didn't feel any difference. 

Dr. Joven-Ching cautions patients about touching their skin after chemical peeling and bleaching.

"After any skin lightening, bleaching, peeling procedure, we advise patients not to pick, scratch, or peel their skin. Direct exposure to heat (sauna, hair dryers, etc) is also to be avoided. Sun protection is a must and sunscreen is best applied 30 minutes prior to exposure (yes, even on a cloudy day). Re-apply every one to two hours if sweating or swimming."

She also gave some reminders about the effects of the proedures.

"Potential effects include further darkening of the skin from chemical burns, skin infections which can rapidly progress to more life-threatening conditions. 

"Patients should consider whether the motivation to lighten their skin [is really what will make them happy] or [do they want to undergo the procedure] because of what society or friends and family deem as beautiful. I always tell my patients: love the skin you're in."

Cost

Prices may vary for different procedures. If you want to try over-the-counter lotions, creams, serums, and pills, price start at P110.

Morie said that the vitamin drip she tried cost her P1,500, while a IV push could range from P550 and above per shot.

As for skin bleaching and chemical peeling, it depends on the clinic or doctor. Upon checking some skin clinic websites, peeling for the face starts from P700, while a whole body peel may cost around P4,500. 

As Dr. Joven-Ching said, it would be best to seek a doctor's advice before undergoing any procedure and spending so much for it. Health is, after all, wealth. – Rappler.com

 

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