We sisters always take care in putting our best face forward, and that doesn’t end with the pride and joy that melanated beauties take in maintaining a timeless visage. Often, it also means treating hyperpigmentation or blemishes under a dermatologist’s care. Many of us rely on a custom skin care routine, medication, or treatments such as microdermabrasion for a flawless complexion. And, of course, we know that diet and exercise go a long way toward maintaining that glow.
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When they notice a blemish or uneven skin tone caused by hyperpigmentation, many sisters are likely to try out a few over-the-counter products to see what works. After all, these products have been marketed to women of color for generations. But if that fade cream or skin-brightening serum you picked up at a department store or drug store or after a facial at a day spa contains the skin-lightening agent hydroquinone, recent health guidelines suggest that you may want to rethink using it as part of a DIY approach.
Under these guidelines, hydroquinone is only legally available by prescription or in products that have obtained specific FDA approval to be sold over the counter.
Some beauty practices can impact health. Last fall, the National Institutes of Health reported a link between hair relaxers and an increased risk of uterine cancer. The study found that Black women may be more affected due to higher rates of use. Similarly, we’re hearing warnings about potential health risks of over-the-counter skin-lightening products. As part of its CARES Act, the Food & Drug Administration (FDA) has put over-the-counter brands that contain hydroquinone on notice because of the potential risks to consumers. Many of the products in question also contain dangerous contaminants like mercury. Under these guidelines, hydroquinone is only legally available by prescription or in products that have obtained specific FDA approval to be sold over the counter.
The news is of concern to women of color globally, especially since darker-skinned women worldwide share concerns about dark spots (more visible in deeply pigmented skin). But more insidiously, nonwhite women in many countries also contend with biased beauty standards favoring lighter skin, as well as discrimination in the job market and dating market, according to White Lies, a CNN investigation “exposing the dangers of skin whitening” and “the underlying drivers of colorism.”
Here in the U.S., decades of affirming “Black is beautiful” messaging and love from within our community have pushed back against that bias over time. As a result, lightening products stateside often promote “even-toned” skin, while marketing in Africa, Asia and the Caribbean sell the promise of lighter or even white skin.
At the heart of it, we have societal pressure and influence. This idea that ‘dark’ is less desirable is not unique to the Black community. I see it in Latinx, East Asian and South Asian cultures.
Nada Elbuluk, M.D., associate professor of clinical dermatology at the University of Southern California, says that when improperly used, skin care products with hydroquinone can cause skin irritation, face swelling and darkening of the skin.
“They aren’t dangerous when used correctly under the guidance of a dermatologist. They can become an issue [however] if used for too long and can cause a condition called ochronosis, which causes increased darkening of the skin and which can be very hard to treat,” Dr. Elbuluk explains.
“The issue is [that] many women purchase products from other countries or from medi-spa places that sell cosmeceuticals and end up using [them] for prolonged periods without supervision. Many people can also get skin irritation from hydroquinone, particularly at higher percentages. When this irritation resolves, it can also cause darkening of the skin called postinflammatory hyperpigmentation. It’s also important that hydroquinone is used for the right indications.”
As alternatives to using over-the-counter skin care products with hydroquinone, Nada Elbuluk, M.D., recommends products with ingredients like soy, licorice root extract, kojic acid, vitamin C and tranexamic acid.
In the U.S., these products are promoted primarily to treat conditions related to hyperpigmentation, like age spots, acne scars and melasma (dark, discolored patches of skin that are common during pregnancy). However, we’d be remiss if we didn’t address the fact that some women of color use these products to bleach and permanently lighten their skin.
“At the heart of it, we have societal pressure and influence. This idea that ‘dark’ is less desirable is not unique to the Black community. I see it in Latinx, East Asian and South Asian cultures. From a young age, society tells darker-skinned women — which is relative for each culture — they are less beautiful,” says Cheri Frey, M.D., assistant professor of dermatology at Howard University.
“Therefore, society has the responsibility to change the face of beauty, from the words we use in advertising, [such as] ‘fair and lovely,’ to the words we use in conversation, [like] ‘Wow, you got dark.’ “ Until that happens, it has to start at home.
As alternatives to using over-the-counter skin care products with hydroquinone to treat hyperpigmentation, Dr. Elbuluk recommends products with ingredients like soy, licorice root extract, kojic acid, vitamin C and tranexamic acid. And when in doubt, make an appointment with a board-certified dermatologist, who can map out a safe and effective skin care regimen.
