India’s obsession with fair skin needs a reality check. According to the beauty industry’s golden rule, one’s natural skin colour can only be realistically determined by the shade behind their ears. Any idea of aspiring to match the tone of one’s chest, midriff, or forearm is but a fleeting dream, for these regions will perpetually appear fairer. It is not possible to alter one’s skin colour to resemble that of a Bollywood celebrity like Aishwarya Rai with injections or any other means. Most Indians have a skin classification of type four or five, which means they possess higher levels of melanin—the pigment that lends colour to human skin.
This desire for a fairer complexion has given rise to a multibillion-dollar skin-lightening industry, resulting in a worrisome trend of skin bleaching and other detrimental beauty practices. Hence, it is essential to dispel the myth that this is a realistic goal for everyone.
Beware of marketing gimmicks
It is disturbing to note the unethical marketing and selling practices that prevail despite the known risks of these products.
Some combination over-the-counter drugs contain potentially harmful ingredients like mercury, steroids, hydroquinone, and glutathione, which can cause skin thinning and lead to a counterblast of pigmentation. The pigment may go initially with these products, but eventually, it will come back with such vengeance that it can even cause kidney failure. Moreover, prolonged use of such products can increase the risk of skin cancer.
The prevalence of this trend is especially concerning in Tier-2 and Tier-3 cities, where people are increasingly pursuing the prospect of fairer skin. The alarming rise of over-toxicity in individuals who use these products underscores the urgent need for stricter control and monitoring. The absence of proper regulatory oversight and medical evaluation, including kidney function testing, is a cause for concern. This issue is more significant than what meets the eye, and it is crucial to address it before it spirals out of control. The government must take measures to restrict skin-whitening products sold without proper regulation.
Microdermabrasion, skin peels, and full-body carbon laser treatments are commonly used in dermatology to improve skin complexion. While these treatments can be effective, some patients opt for whitening injections containing glutathione. Glutathione is an anti-oxidant that occurs naturally in the skin and, when administered externally, can help reduce pigmentation by inhibiting tyrosinase, an enzyme involved in melanin production. It is important to note that the success of this treatment depends on the patient being chosen wisely, and the dosage varies from person to person. However, if performed correctly, glutathione treatments can be an effective way to achieve skin whitening.
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What is glutathione?
Glutathione is being marketed as the holy grail product for those seeking to lighten their skin tone. It is available in various forms, such as injections, tablets, sublingual pills and patches. This naturally occurring substance is produced by the liver and plays a crucial role in the body’s anti-oxidant defence system. It helps with tissue building and repair, free radical neutralisation, immune system support, anti-cancer activity, and even has anti-ageing benefits. However, as we age, the glutathione levels in our liver reduce, leading to pigmentation, wrinkles, and sagging skin.
To lighten the skin tone and reap the other health benefits of glutathione, doctors usually prescribe a dosage of 600 to 1200 mg once or twice a week for one to two months. However, the required dosage may be higher for those with severe skin conditions such as eczema, psoriasis and atopic dermatitis, and treatment may need to be continued for longer. Moreover, only L-glutathione, the active form of glutathione, is appropriate for use. Other forms of glutathione, usually present in tablets, may not be as effective.
Taking other anti-oxidants like vitamins C and E, carotenoids, and selenium is better. As far as L-glutathione is concerned, it should be taken on an empty stomach, ideally in sublingual form, i.e., under the tongue or through intravenous (IV) drug therapy.
As a dermatologist, I feel that only the injection form works because the substance bypasses the digestive system to enter the bloodstream directly, proving more effective than other forms of treatment available.
However, limited evidence supports Glutathione’s use for skin lightening. For starters, its use as a parenteral formulation (suspension or solution for injecting into the body) is only approved for severe liver disorders and the prevention of chemotherapy-associated nerve damage in India. While glutathione has been marketed as a dietary supplement in the US, the Philippines has only approved its (injectable) use for cancer patients at risk of side effects from platinum-based chemotherapy. Despite this, it is being used unchecked for skin lightening in many countries.
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Switch to healthier alternatives
The only way to achieve healthy and radiant skin is by embracing one’s natural colour and following a rigorous protection regime. This includes shielding it from environmental factors such as pollution and ultraviolet radiation and using products suitable for one’s skin type. By doing so, individuals can achieve their best skin and feel confident in their natural beauty.
Instead of resorting to cosmetic treatments for skin whitening, one can achieve a bright and even complexion by following simple tips. First and foremost, it is important to maintain a healthy diet rich in anti-oxidants. Anti-oxidants such as Vitamin C and beta-carotenes can ally and fight sun-induced damage internally. Drinking at least a gallon of water daily is essential to keep your skin hydrated and glowing. Moreover, sunscreen should be applied diligently to protect your skin from the sun’s harmful rays.
Restful sleep is also a key factor in revitalising and rejuvenating the skin. A routine cleansing detox can help flush out impurities, and applying nourishing night creams can help replenish the skin’s moisture. Vitamin C serums and various skin ointments with berry extracts can help reduce tanning. Start with the lowest concentration and patch test each product to reap maximum benefits.
Last, indulging in the luxurious ritual of a relaxing oil massage can enhance skin texture and radiance. One can achieve a healthy, glowing complexion by following these simple tips.
As a dermatologist, I always advise my patients to be cautious when it comes to skin whitening. It’s important to consult a qualified professional and choose products and treatments that are safe and appropriate for your skin type. Maintaining a healthy skincare routine and avoiding excessive sun exposure can help maintain a brighter and even skin tone—be it any shade.
Dr Deepali Bhardwaj is a dermatologist, anti-allergy specialist, laser surgeon and internationally trained aesthetician. She tweets @dermatdoc. Views are personal.
(Edited by Zoya Bhatti)