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The use of medical products to lighten skin colour could lead to serious complications due to their side effects.

Skin lightening appears to be a common practice among dark skinned individuals, and has been linked to side effects ranging from disfiguring scarring to system-wide health problems. However, there have been few reports on complications due to use of these products from industrialised nations such as France and the United States.

Researchers from the Hospital Saint Louis, Paris analysed a group of 46 people and identified two with insufficient adrenal gland function that was due to use of clobetasol, which is illegal in France. Others had hyperpigmentation, stretch marks, skin atrophy (degeneration) and infections that could have been related to the use of skin lightening products. Many patients reported being unable to stop trying to lighten their skin even though they wanted to. This particular feature of skin lightening is like addictive behaviour, sometimes associated with real psychological suffering. To investigate, the researchers examined 46 patients of African descent who had changes in their skin that could have been due to use of skin lightening products. These included excessive darkening of the skin on the finger joints, atrophy of the skin, stretch marks and infections.

Twenty five of the men and women in the study reported using skin lightening products, 12 said they were attempting to stop using the products, 7 said they had used them in the past but no longer did, and two said they had never used the products. On average, people reported having used skin lighteners for 14 years, with time of use ranging from one to 38 years. All people who reported lightening their skin said they had used at least two products in combination, generally glucocorticoids (use of which could theoretically lead to diabetes and high blood pressure), hydroquinone, or clobetasol. Nine people referred to skin lightening as a true drug, while many reported having difficulty stopping the use of these products even if they were unsatisfied with their effects. Frequently patients would look for more powerful products to cope with the hyperpigmentation side effects they experienced.

While some participants in the study had high blood pressure and diabetes, it was impossible to determine if it was due to the use of skin lightening products. But the researchers did find two cases of adrenal insufficiency that they attributed to clobetasol use, noting that people in the study used up to 480 grams weekly, while 50 grams weekly is enough to affect adrenal gland function.

This study aims to inform dark-skinned persons of the nature and side effects of the products used for skin lightening, especially clobetasol.