MarketSkin whitening
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Skin whitening

Skin whitening, also known as skin lightening and skin bleaching, is the practice of using chemical substances in an attempt to lighten the skin or provide an even skin color by reducing the melanin concentration in the skin. Several chemicals have been shown to be effective in skin whitening, while some have proven to be toxic or have questionable safety profiles. This includes mercury compounds which may cause neurological problems and kidney problems.

Use
Areas of increased pigmentation such as moles may be depigmented to match the surrounding skin. Effective agents for specific areas include corticosteroids, tretinoin, and hydroquinone. This may be done for reasons of appearance, politics, or economics. Skin lighteners' main health risks are linked to (i) The overuse of topical clobetasol, which can cause systemic steroid effects from daily usage, especially on broad skin regions; and (ii) concealed mercury content, which can lead to mercury poisoning depending on individual susceptibility. Many skin whiteners contain a toxic form of mercury as the active ingredient. == Types ==
Types
Hydroquinone is a commonly used agent in skin whiteners. The European Union banned it from cosmetics in 2000. It works by decreasing melanin production. It can be used as a cream. Due to side effects that may result from intravenous use, the government of the Philippines recommends against such use. • One 2017 review found tentative evidence of benefit of tranexamic acid in melasma. Another 2017 review found that evidence to support its use was insufficient. • Azelaic acid may be a second-line option for melasma. • Decapaptide-12 and related peptides which act as tyrosinase inhibitors have been used as skin-lightening agents. • A number of types of laser treatments have been used in melasma with some evidence of benefit. Reoccurrence is common, and certain types of lasers can result in more pigmentation. == Side effects ==
Side effects
Skin lightening creams have commonly contained mercury, hydroquinone, and corticosteroids. Because these compounds can induce both superficial and internal side effects, they are illegal to use and market in multiple nations. However, various chemical studies indicate that these compounds continue to be used in sold cosmetic products, though they are not explicitly declared as ingredients. Mercury toxicity can cause acute symptoms such as pneumonitis and gastric irritation. A study by Pascal del Giudice and Pinier Yves indicated that hydroquinone usage is strongly correlated with the development of ochronosis, cataracts, patchy depigmentation, and contact dermatitis. Ochronosis can lead to lesions and squamous cell carcinomas. While hydroquinone has not been officially classified as a carcinogen, it can metabolize into carcinogenic derivatives and induce genetic changes in the form of DNA damages. Corticosteroids have become some of the most commonly incorporated lightening agents. Long-term usage over large areas of skin may promote percutaneous absorption, which can produce complications such as skin atrophy and fragility, glaucoma, cataracts, edemas, osteoporosis, menstrual irregularities, and growth suppression. A 2000 study performed in Dakar, Senegal, indicated that chronic usage of skin lighteners was a risk factor for hypertension and diabetes. Chemically lightened skin is more highly susceptible to sun damage and dermal infection. Long-term users of skin bleachers can easily develop fungal infections and viral warts. Pregnant users may also experience health complications for both them and their children. ==Rate of usage ==
Rate of usage
In 2013, 77% of Nigerian women, 52% of Senegalese women, and 25% of Malian women were using lightening products. In 2020, Der Spiegel reported that in Ghana, "When You Are Light-Skinned, You Earn More", and that "[s]ome pregnant women take tablets in the hopes that it will lead their child to be born with fair skin. Some apply bleaching lotion [...] to their babies, in the hopes that it will improve their child's chances." Skin whiteners typically range widely in pricing. Olumide attributes this to the desire to portray whitening as financially accessible to all. A study by Lester Davids and his colleagues indicated that nations in Africa present high rates of usage for skin bleachers. Though many products have been banned due to toxic chemical compositions, Davids found that regulating policies are often not strictly enforced. By 2018, the industry for lightening cosmetics in India had achieved a net worth of nearly $180 million and an annual growth rate of 15%. As of 2013, the global market for skin lighteners was projected to reach $19.8 billion by 2018, based on sales growth primarily in Africa, Asia, and the Middle East. In the United Kingdom, many skin whiteners are illegal due to possible adverse effects. Such products are frequently still sold even after shops have been prosecuted. Trading standards departments lack the resources to deal with the problem effectively. == Motivations ==
Motivations
According to Yetunde Mercy Olumide, advertisements for skin lighteners often present their products as stepping stones to attain greater social capital. For example, representatives of India's Glow & Lovely cosmetics asserted that their products allowed for socioeconomic mobility, akin to education. In 2009, historian Evelyn Nakano Glenn attributed sensitivities to skin tone among African Americans to the history of slavery. Lighter-skinned African Americans were perceived to be more intelligent and skilled than dark-skinned African Americans, who were relegated to more physically taxing, manual labor. In 2011, sociologist Margaret Hunter noted the influence of mass-marketing and celebrity culture emphasizing whiteness as an ideal of beauty. The K-pop and K-drama industries are generally saturated with fair-skinned celebrities, some of whom serve as brand ambassadors and beauty ideals. The increasing popularity of South Korean culture and K-beauty has been a factor in popularizing the skin whitening trend elsewhere in Asia, especially in poorer countries like Thailand, where many have begun to use unsafe skin-whitening products. In Nepal, cultural influence from Bollywood, which prominently features lighter skinned lead actors, has been linked to the use of skin whitening creams among some darker-skinned men. Other motivations for skin whitening include desiring softer skin and wanting to conceal discolorations arising from pimples, rashes, or chronic skin conditions. ==Mechanism of action==
Mechanism of action
Skin whitening agents work by reducing the presence of melanin pigment in the skin. To accomplish this, there are several possible mechanisms of action: • Inhibition of the activity of tyrosinase: The catalytic action of tyrosinase is inhibited by the skin whitening agent. • Inhibition of the expression or activation of tyrosinase: The anti melanogenic agent causes less tyrosinase to be generated or prevents tyrosinase from being activated to its functional form. • Scavenging of the intermediate products of melanin synthesis. • Preventing the transfer of melanosomes to keratinocytes. • Directly destroying existing melanin. • Destroying melanocytes. Inhibition of tyrosinase Upregulation of tyrosinase caused by tyrosinase inhibitors. Several skin whitening agents, including tyrosinase inhibitors, have been found to cause an increase in the expression of tyrosinase, which by itself would increase melanin synthesis. Microphthalmia-associated transcription factor (MITF) is the master transcription factor that controls the expression of TYR, TRP1, and TRP2, MART1, PMEL17, and many other important proteins involved in the function of melanocytes. Downregulation of MITF decreases melanogenesis and is a mechanism of action of some skin whitening agents. Various signaling pathways and genetic mutations influence the expression of MITF. MC1R receptor and cAMP The melanocortin 1 receptor (MC1R) is a transmembrane and G-protein coupled receptor expressed in melanocytes. MC1R is an important target for the regulation of melanogenesis. Agonism of MC1R increases the ratio of eumelanin to pheomelanin and increases the generation of melanin overall. The MC1R and cAMP signaling pathway starts with the activation of MC1R, which causes activation of adenylyl cyclase (AC), which produces cyclic adenosine monophosphate (cAMP), which activates protein kinase A (PKA), which activates by protein phosphorylation cAMP response element-binding protein (CREB), which upregulates MITF, of which CREB is a transcription factor. Alpha-melanocyte stimulating hormone (α-MSH), beta-melanocyte stimulating hormone (β-MSH), and adrenocorticotropic hormone are endogenous agonists of MC1R. Agouti signaling protein (ASIP) appears to be the only endogenous antagonist of MC1R. Synthetic MC1R agonists have been designed, such as the peptides afamelanotide and melanotan II. Mutations of the MC1R gene correlate are at least partially responsible for red hair, white skin, and an increased risk for skin cancer in some individuals. Transfer of melanosomes Within the skin, melanocytes are present in the basal layer of the epidermis; from these, melanocytes originate dendrites that reach keratinocytes. Melanosomes, along with the melanin they contain, are transferred from melanocytes to keratinocytes when keratinocytes are low in the epidermis. Keratinocytes carry the melanosomes with them as they move toward the surface. Keratinocytes contribute to skin pigmentation by holding the melanin originating in melanocytes and inducing melanogenesis through chemical signals directed at melanocytes. The transfer of melanosomes to keratinocytes is a necessary condition for the visible pigmentation of the skin. Blocking this transfer is a mechanism of action of some skin whitening agents. The protease-activated receptor 2 (PAR2) is a transmembrane and G-protein coupled receptor expressed in keratinocytes and involved in melanocyte transfer. Antagonists of PAR2 inhibit the transfer of melanosomes and have skin whitening effects, while agonists of PAR2 have the opposite effect. Destroying melanocytes Some compounds are known to destroy melanocytes; this mechanism of action is often used to remove the remaining pigmentation in cases of vitiligo. == History ==
History
Early skin whitening practices were not well-documented. Skin whitening is a practice that has made its way across the entire globe with a multitude of cultures adopting the practice under various ideologies. Commonly, the practice has been marketed towards women under the pretense that porcelain skin was the ideal representation of beauty and status. The first recorded practices of skin whitening can be traced back to over 200 B.C. across a multitude of civilizations that utilized natural sources of ingredients to facilitate the production of skin whitening substances. One of these methods include the use of honey and olive oil as a method of whitening the skin in different civilizations such as in Egypt as well as in Greek culture. More specifically, out of the four stages associated with this theory, the first one, named the "pre-encounter" stage, highlights the underlying concept one not associating themselves with their own culture or values due partly to the misinformation one has been taught to believe and therefore seeks validation and worthiness from those who have misinformed that person. Ancient Asian cultures also associated light skin with feminine beauty. "Jade" white skin in Korea is known to have been the ideal as far back as the Gojoseon era. Japan's Edo period saw the start of a trend of women whitening their faces with rice powder as a "moral duty". Chinese women valued a "milk white" complexion and swallowed powdered pearls towards that end. Skin-lightening practices had achieved great importance in East Asia as early as the 16th century. Following the Meiji restoration, men and women reserved white lead makeup and traditional attire for special occasions. Historians also noted that as East Asian women immigrated to the United States, immigrant women engaged in skin lightening more frequently than women who did not immigrate. Skincare products that are recognized to protect the skin included chemicals that assist in skin whitening. Multiple studies find that preferences for lighter skin in India were historically linked to both the Indian caste system and centuries of outside rule by light-skinned nations. In the Philippines and many Southeast Asian countries, lighter skin was associated with higher social status. While pale skin suggested being away from the sun, darker skin signified the result of working in external conditions. With colonial influence from Britain's occupation, there was a distinction in superiority and inferiority. and Saudi Arabia. This practice has been attributed to a perceived association between light skin and beauty, as well as marriage and employment opportunities. Bleaching cosmetics often incorporated white lead carbonate and mercury as lightening agents. According to medieval historians, light skin was an indicator of aristocracy and higher socioeconomic class, as laborers were more frequently exposed to outdoor sunlight. Men and women lightened their skin superficially and chemically, using white powder and Venetian ceruse, respectively. In the 2015 book, Skin bleaching in Black Atlantic zones: shade shifters, author Shirley Anne Tate writes that skin lightening was often not well-received in Black culture. Women in Black cultures who used skin whiteners were described as artificial, while Black men who used skin whiteners were described as overly effeminate. Historians credited the increased marketing of skin whiteners to the culture of the Jim Crow era, as black Americans faced continued social and legal restrictions. Recovered journals from women in Suriname indicated that they used vegetable mixtures to lighten their skin, which produced painful side effects. The ideologies behind blanqueamiento promoted the idea of social hierarchy, based on Eurocentric features and skin tone. Africa Records indicate prominent usage of skin lighteners in South Africa beginning in the 20th century. Skin lighteners in South Africa were first marketed to white consumers, then eventually to consumers of color. Initially, skin whitening was typically practiced by rural and poor South African women; however, studies indicate that the practice has become increasingly prevalent among black women with higher incomes and levels of education. By the 1980s, critiques of skin whitening had become incorporated into the anti-apartheid movement, given skin-whitening's adverse consequences on health and its social implications of colorism. Maya Allen attributed this to the increased flow of European products and commercial influence into colonized regions. Several historians have suggested that the increased prevalence of skin whitening in "the Global South" is potentially tied to both precolonial notions of beauty and post-colonial hierarchies of race. == Health hazards ==
Health hazards
Several chemical substances have been found to be effective in skin whitening, but some have been proven or suspected to be toxic. This includes compounds containing mercury, which can cause neurological and kidney problems. These products also contain collagen, which can be harmful to the skin. It is present in day creams and beauty masks. Collagen is an insoluble fibrous protein that is too large to penetrate the skin, thus it can clog pores. The use of these products can be hazardous to health, potentially causing acne, stretch marks, skin cancer, hypertension, or diabetes, especially when the product contains hydroquinone, mercury, cortisone, or vitamin A. Allergic reactions or undesirable effects such as uneven hyperpigmentation or patchy depigmentation can also occur. Among the ingredients, hydroquinone is also commonly found and is responsible for multiple side effects. It can interfere with the reagents used in capillary blood glucose meters, artificially raising blood glucose levels. In 1997, in Paris, the French police dismantled a network involved in the illegal trafficking of skin lightening products, primarily targeting Congolese migrants. Such products represent a significant market despite their health risks. Users resort to preparations containing mercury or bleach, or products containing corticosteroids or quinine. The Saint-Louis Hospital in Paris had to establish a specialized department to deal with the skin disorders caused by skin bleaching. The World Health Organization (WHO) has noted the significant presence of inorganic mercury added to skin lightening products, which is known to be associated with skin cancer. ==See also==
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